NPIMap

Organization Active NPI

Lighthouse Support Services, Inc.

  • Assisted Living Facility (Behavioral Disturbances)
  • Port St Lucie, FL
National Provider Identifier
1437127487
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X
License
F001 Issued in FL
Legal business name
LIGHTHOUSE SUPPORT SERVICES, INC.
Practice address
826 SE Sweetbay Ave
Port St Lucie, FL 34983-4647
Phone
(772) 344-4954
Fax
(772) 344-5875
NPI assigned
Mar 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Ruben Cancel
Title
Ceo
Phone
(772) 344-4954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X F001 FL Primary

Addresses

Primary practice location

826 SE Sweetbay Ave
Port St Lucie, FL 34983-4647

Mailing address

826 SE Sweetbay Ave
Port St Lucie, FL 34983-4647
Phone (772) 344-4954

Other names 1

  • LIGHTHOUSE GROUP HOME Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1437127487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 SE SWEETBAY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349834647",
            "telephone_number": "772-344-4954",
            "fax_number": "772-344-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 SE SWEETBAY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349834647",
            "telephone_number": "772-344-4954",
            "fax_number": "772-344-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE SUPPORT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CANCEL",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-344-4954",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "FL",
            "license": "F001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIGHTHOUSE GROUP HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.