Organization Active NPI

Lighthouse of Hope & Healing, LLC

  • Community/Behavioral Health Agency
  • Jefferson City, MO
National Provider Identifier
1073135620
Registry record updated May 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIGHTHOUSE OF HOPE & HEALING, LLC
Practice address
1026 Northeast Dr Ste B
Jefferson City, MO 65109-2517
Phone
(573) 690-7919
Fax
(573) 636-7771
NPI assigned
May 16, 2020
Last updated
May 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2020

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

Authorized official

Name
Christina L Sanni
Title
Owner
Phone
(573) 690-7919

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1026 Northeast Dr Ste B
Jefferson City, MO 65109-2517

Mailing address

PO Box 105755
Jefferson City, MO 65110-5755
Phone (573) 690-7919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231206001397 MO Part B Supplier - Clinic/Group Practice 4981053758 Receives reassigned benefits from 1 practitioner
Practice locations: Jefferson City, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1589587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589587200000",
    "number": "1073135620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 105755",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651105755",
            "telephone_number": "573-690-7919",
            "fax_number": "573-636-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 NORTHEAST DR STE B",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651092517",
            "telephone_number": "573-690-7919",
            "fax_number": "573-636-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE OF HOPE & HEALING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-16",
        "last_updated": "2020-05-16",
        "certification_date": "2020-05-16",
        "status": "A",
        "authorized_official_last_name": "SANNI",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-690-7919"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.