NPIMap

Organization Active NPI

Lighthouse Community Investment Agency Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Williamson, WV
National Provider Identifier
1437635141
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
LIGHTHOUSE COMMUNITY INVESTMENT AGENCY INC
Practice address
102 Prichard Street
Williamson, WV 25661
Phone
(304) 475-4663
Fax
(304) 475-1450
NPI assigned
Jul 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Authorized official

Name
Mr. Justin Scott Ross
Title
HR
Phone
(304) 475-4663

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

102 Prichard Street
Williamson, WV 25661

Mailing address

102 Prichard Street
Williamson, WV 25661

Other names 1

  • Lighthouse Recovery Center Doing business as

National Provider Directory

National Provider Directory

Locations

201 Prichard St
Williamson, WV 25661
Phone (304) 235-0122

Practitioners & affiliated clinicians

Practitioners 6

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": "1531699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531699200000",
    "number": "1437635141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PRICHARD STREET",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "25661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PRICHARD STREET",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "25661",
            "telephone_number": "304-475-4663",
            "fax_number": "304-475-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE COMMUNITY INVESTMENT AGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-16",
        "last_updated": "2018-07-16",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "HR",
        "authorized_official_telephone_number": "304-475-4663",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lighthouse Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamson, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; 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.