NPIMap

Organization Active NPI

Light House Recovery Services

  • Community/Behavioral Health Agency
  • Fargo, ND
National Provider Identifier
1144920828
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIGHT HOUSE RECOVERY SERVICES
Practice address
921 2ND Ave S
Fargo, ND 58103-1705
Phone
(701) 361-9922
NPI assigned
Mar 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Authorized official

Name
Tara Gilbert
Title
Peer Support Administrator
Phone
(218) 790-8445

Specialties & licenses 1

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

Addresses

Primary practice location

921 2ND Ave S
Fargo, ND 58103-1705

Mailing address

921 2ND Ave S
Fargo, ND 58103-1705

National Provider Directory

National Provider Directory

Locations

921 2nd Ave S
Fargo, ND 58103
Phone (701) 318-8204

Practitioners & affiliated clinicians

Practitioners 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1144920828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 2ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 2ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031705",
            "telephone_number": "701-361-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT HOUSE RECOVERY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "GILBERT",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "PEER SUPPORT ADMINISTRATOR",
        "authorized_official_telephone_number": "218-790-8445"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.