Organization Active NPI

Lighthouse Homecare Assistance LLC

  • In Home Supportive Care Agency
  • Grand Rapids, MI
National Provider Identifier
1336953298
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
LIGHTHOUSE HOMECARE ASSISTANCE LLC
Practice address
1509 Philadelphia Ave SE
Grand Rapids, MI 49507-2235
Phone
(313) 618-8646
NPI assigned
Feb 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Authorized official

Name
Aireona Iyon GreenNPI 1376354613
Title
Ceo
Phone
(313) 618-8646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

1509 Philadelphia Ave SE
Grand Rapids, MI 49507-2235

Mailing address

1509 Philadelphia Ave SE
Grand Rapids, MI 49507-2235
Phone (313) 618-8646

Other names 1

  • LightHouse HomeCare Assistance LLC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738540800000",
    "number": "1336953298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 PHILADELPHIA AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072235",
            "telephone_number": "313-618-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 PHILADELPHIA AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072235",
            "telephone_number": "313-618-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE HOMECARE ASSISTANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "AIREONA",
        "authorized_official_middle_name": "IYON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-618-8646"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LightHouse HomeCare Assistance LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.