Active NPI
Lighthouse Healthcare Management South LLC
- Assisted Living Facility
- Pompano Beach, FL
National Provider Identifier
1619374147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL7127
- Legal business name
- LIGHTHOUSE HEALTHCARE MANAGEMENT SOUTH LLC
- Practice address
- 3305 SE 5TH St
Pompano Beach, FL 33062-5509 - Phone
- (954) 785-7763
- NPI assigned
- Nov 26, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Samuel Tennenbaum
- Title
- Cfo
- Phone
- (212) 616-8819
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL7127 | FL | Primary |
Addresses
Primary practice location
3305 SE 5TH St
Pompano Beach, FL 33062-5509
Mailing address
555 Madison Ave
19TH Floor
New York, NY 10022-3301
Phone (212) 616-8819
Other names 1
- Lighthouse Inn South
National Provider Directory
National Provider DirectoryLocations
3305 SE 5th St
Pompano Beach, FL 33062
Phone (954) 783-2317
555 Madison Ave
Fl 19
New York, NY 10022
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416960000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1416960000000",
"number": "1619374147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 MADISON AVE",
"address_2": "19TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100223301",
"telephone_number": "212-616-8819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3305 SE 5TH ST",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330625509",
"telephone_number": "954-785-7763"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIGHTHOUSE HEALTHCARE MANAGEMENT SOUTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2014-11-26",
"last_updated": "2014-11-26",
"status": "A",
"authorized_official_last_name": "TENNENBAUM",
"authorized_official_first_name": "SAMUEL",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "212-616-8819"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "FL",
"license": "AL7127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lighthouse Inn South",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Pompano Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.