Organization Active NPI

Lighthouse Recovery Residences, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Elizabethtown, KY
National Provider Identifier
1053232108
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
LIGHTHOUSE RECOVERY RESIDENCES, LLC
Practice address
120 S Mantle Ave
Elizabethtown, KY 42701-1606
Phone
(502) 417-9675
Fax
(270) 360-0840
NPI assigned
Jul 23, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Authorized official

Name
Amanda Metcalfe
Title
Owner
Phone
(270) 234-0003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

120 S Mantle Ave
Elizabethtown, KY 42701-1606

Mailing address

120 S Mantle Ave
Elizabethtown, KY 42701-1606
Phone (502) 417-9675

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1784764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1053232108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S MANTLE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011606",
            "telephone_number": "502-417-9675",
            "fax_number": "270-360-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S MANTLE AVE",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427011606",
            "telephone_number": "502-417-9675",
            "fax_number": "270-360-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE RECOVERY RESIDENCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "METCALFE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-234-0003"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.