LP Lighthouse LLC

Primary specialty

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

Legal business name

LP LIGHTHOUSE LLC

Practice address

25820 Southfield Rd Ste 202
Southfield, MI 48075-1828

Phone

(248) 234-8533

Fax

(248) 234-8533

NPI assigned

Apr 18, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Larry D Pruitt

Title

Owner

Phone

(248) 234-8533

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1295189173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25820 SOUTHFIELD RD STE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751828",
            "telephone_number": "248-234-8533",
            "fax_number": "248-234-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25820 SOUTHFIELD RD STE 202",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751828",
            "telephone_number": "248-234-8533",
            "fax_number": "248-234-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LP LIGHTHOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-234-8533",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Southfield, MI
• Providers in Southfield, MI by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.