NPIMap

Organization Active NPI

Lighthouse Home Care Agency LLC

  • In Home Supportive Care Agency
  • Winston Salem, NC
National Provider Identifier
1639892474
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
LIGHTHOUSE HOME CARE AGENCY LLC
Practice address
615 Saint George Square CT Ste 300
Winston Salem, NC 27103-1368
Phone
(202) 294-7522
NPI assigned
Sep 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Authorized official

Name
Ogechukwu EzechukwuNPI 1457822322
Title
Owner
Phone
(202) 294-7522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

615 Saint George Square CT Ste 300
Winston Salem, NC 27103-1368

Mailing address

615 Saint George Square CT Ste 300
Winston Salem, NC 27103-1368

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1639892474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SAINT GEORGE SQUARE CT STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SAINT GEORGE SQUARE CT STE 300",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031368",
            "telephone_number": "202-294-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE HOME CARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A",
        "authorized_official_last_name": "EZECHUKWU",
        "authorized_official_first_name": "OGECHUKWU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-294-7522"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.