Lighthouse Premium Home Care LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

LIGHTHOUSE PREMIUM HOME CARE LLC

Practice address

3300 County Road 10
Ste 200D
Brooklyn Center, MN 55429

Phone

(612) 886-4585

NPI assigned

Nov 19, 2024

Organization subpart

No

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

Authorized official

Name

Oswald DemaNPI 1265257877

Title

Owner

Phone

(612) 886-4585

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Oswald Dema

  • Home Health Agency
  • Brooklyn Center, MN
  • NPI 1265257877
  NPD Authorized official

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1548085079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 COUNTY ROAD 10",
            "address_2": "STE 200D",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "55429",
            "telephone_number": "612-886-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 COUNTY ROAD 10",
            "address_2": "STE 200D",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "55429",
            "telephone_number": "612-886-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE PREMIUM HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "DEMA",
        "authorized_official_first_name": "OSWALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-886-4585"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Nursing Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.