Lighthouse Support Services Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

LIGHTHOUSE SUPPORT SERVICES INC.

Practice address

3055 Old Highway 8 Ste 107
St Anthony, MN 55418-2500

Phone

(612) 987-4345

NPI assigned

Aug 16, 2022

Last updated

Aug 16, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sucdi DahirNPI 1043810344

Title

Owner

Phone

(612) 987-4345

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Sucdi Ahmed Dahir

  • Behavior Technician
  • Minneapolis, MN
  • NPI 1043810344
  NPD Authorized official

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1316665227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3055 OLD HIGHWAY 8 STE 107",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554182500",
            "telephone_number": "612-987-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3055 OLD HIGHWAY 8 STE 107",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554182500",
            "telephone_number": "612-987-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE SUPPORT SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "DAHIR",
        "authorized_official_first_name": "SUCDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-987-4345"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in St Anthony, MN
• Providers in St Anthony, MN by specialty
• In Home Supportive Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.