Lighthouse Residential Home

Primary specialty

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

Legal business name

LIGHTHOUSE RESIDENTIAL HOME

Practice address

5219 Summerleaf Dr
North Chesterfield, VA 23234-2817

Phone

(804) 337-1403

Fax

(804) 590-2763

NPI assigned

Mar 23, 2020

Organization subpart

No

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

Authorized official

Name

Robert Earl Owens Jr.

Title

President

Phone

(804) 337-1403

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586390400000",
    "number": "1407483316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13518 MARSH ELDER CT",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238383406",
            "telephone_number": "804-337-1403",
            "fax_number": "804-590-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5219 SUMMERLEAF DR",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232342817",
            "telephone_number": "804-337-1403",
            "fax_number": "804-590-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE RESIDENTIAL HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-337-1403",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rowens@lighthouse-residential.com",
            "affiliation": "N",
            "endpointDescription": "Company Secured email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5219 Summerleaf Dr",
            "city": "North Chesterfield",
            "state": "VA",
            "country_code": "US",
            "postal_code": "232342817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Darren Liu, PHARMD
• Harry Liu, MD

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

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