The Light House LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

THE LIGHT HOUSE LLC

Practice address

116 Yester Oaks Way E Apt J
Greensboro, NC 27455-3140

Phone

(336) 324-7223

NPI assigned

Nov 27, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Temuka Hoskins HendrixNPI 1972320695

Title

Owner

Phone

(336) 324-7223

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Temuka H Hendrix

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Greensboro, NC
  • NPI 1972320695

  Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1013733625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 YESTER OAKS WAY E APT J",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274553140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 YESTER OAKS WAY E APT J",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274553140",
            "telephone_number": "336-324-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LIGHT HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "TEMUKA",
        "authorized_official_middle_name": "HOSKINS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-324-7223"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Greensboro, NC
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.