Lighthouse Personal Care Home,LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LIGHTHOUSE PERSONAL CARE HOME,LLC

Practice address

824 SW Hillside Dr
Burleson, TX 76028-5237

Phone

(601) 573-3116

Fax

(601) 573-3116

NPI assigned

Aug 7, 2025

Organization subpart

No

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

Authorized official

Name

Revera White

Title

Ceo

Phone

(469) 806-9551

Specialties & licenses 1

Addresses

Other names 1

• LIGHTHOUSE PERSONAL CARE HOME, LLC Other name

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

{
    "created_epoch": "1754524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1073498226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 WINDING FOREST CT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750526692",
            "telephone_number": "469-806-9551",
            "fax_number": "469-806-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 SW HILLSIDE DR",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760285237",
            "telephone_number": "601-573-3116",
            "fax_number": "601-573-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE PERSONAL CARE HOME,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-07",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "REVERA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-806-9551"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIGHTHOUSE PERSONAL CARE HOME, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kelly Anne Levasseur, RDN, LD
• Randy Michael Lew, D.P.M.
• Danielle Nicole Lewis
• Lifevantage Home Health, LLC
• Skye Lightfoot
• Theodore J Lilly, M.D.
• Jeffrey C Lin, M.D.
• Ridge Logan
• Brittney London
• Lone Star Orthopaedic and Spine Specialists, PLLC

• Assisted Living Facility in Burleson, TX
• Providers in Burleson, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.