The Harbor Lighthouse

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

ALH-4783 Issued in AZ

Legal business name

THE HARBOR LIGHTHOUSE

Practice address

5940 W Pershing Ave
Glendale, AZ 85304-1123

Phone

(623) 773-9464

NPI assigned

Oct 4, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Nicolae Lucian Negrea

Title

Owner

Phone

(623) 773-9464

Specialties & licenses 1

Addresses

Tax ID family

The Harbor Lighthouse2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Harbor Lighthouse Care Home II

  • Adult Care Home Facility
  • Glendale, AZ
  • NPI 1689661639
  NPD tax ID

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306833355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5940 W PERSHING AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041123",
            "telephone_number": "623-773-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 W PERSHING AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041123",
            "telephone_number": "623-773-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HARBOR LIGHTHOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEGREA",
        "authorized_official_first_name": "NICOLAE",
        "authorized_official_middle_name": "LUCIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-773-9464",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "ALH-4783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Adult Care Home Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.