The Harbor Lighthouse Care Home II

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

ALH-5179 Issued in AZ

Legal business name

THE HARBOR LIGHTHOUSE CARE HOME II

Practice address

4142 W Grovers Ave
Glendale, AZ 85308-2926

Phone

(602) 334-1114

Fax

(623) 773-9464

NPI assigned

Oct 4, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Nicolae Lucian Negrea

Title

Owner

Phone

(602) 334-1114

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

The Harbor Lighthouse2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Harbor Lighthouse

  • Adult Care Home Facility
  • Glendale, AZ
  • NPI 1306833355
  NPD tax ID

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1689661639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4142 W GROVERS AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853082926",
            "telephone_number": "602-334-1114",
            "fax_number": "623-773-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4142 W GROVERS AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853082926",
            "telephone_number": "602-334-1114",
            "fax_number": "623-773-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HARBOR LIGHTHOUSE CARE HOME II",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "NEGREA",
        "authorized_official_first_name": "NICOLAE",
        "authorized_official_middle_name": "LUCIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-334-1114",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "AZ",
            "license": "ALH-5179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Adult Care Home Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.