LIGHTHOUSE COMMUNITY INVESTMENT AGENCY INC (NPI# 1437635141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437635141 |
| Entity Type | Organization |
| Organization Name | LIGHTHOUSE COMMUNITY INVESTMENT AGENCY INC |
| Other Organization Name | LIGHTHOUSE RECOVERY CENTER |
| Practice Address |
102 Prichard Street Williamson WV 25661 |
| Practice Telephone | 3044754663 |
| Practice Fax Number | 3044751450 |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-07-16 |
| Authorized Official Name | MR. JUSTIN SCOTT ROSS (HR) |
| Authorized Official Telephone | 3044754663 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Lighthouse Recovery Center | Doing Business As Name - Organization |
| Street Address |
102 PRICHARD STREET |
| City | WILLIAMSON |
| State | WV |
| Zip Code | 25661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093315715 | Leah Danielle Davis | Technician | Rr 1 200b, Left Fork Marrowbone, Williamson, WV 25661 | 2020-10-30 |
| 1487253209 | Rosalene Diamond | Technician | 398 Davis Branch Road, Wiilliamson, WV 25661 | 2020-10-22 |
| 1295332021 | Mary Ann Hickman | Technician | 144 Lincoln Street, Williamson, WV 25661 | 2020-10-05 |
| 1194322917 | Randy Lee Davis | Technician | 511 Dickerson Street Apt. #7, Williamson, WV 25661 | 2020-10-05 |
| 1679188320 | Deborah Ann Smith | Technician | 25 Ben Street, Williamson, WV 25661 | 2020-09-10 |
| 1356956262 | Jessica Ann Payne | Technician | 1203 Buffalo Creek Road, Lot#1, Williamson, WV 25661 | 2020-09-09 |
| 1154934396 | Jahala Kay Kozee | Technician | 164 Us Rt. 52, Williamson, WV 25661 | 2020-08-27 |
| 1952914186 | Ruth Elaine Kirk | Technician | 45 Wincole Lane, Williamson, WV 25661 | 2020-08-27 |
| 1831702208 | Mary Elizabeth Gilman | Technician | 436 State Route 65, Williamson, WV 25661 | 2020-08-26 |
| 1437760253 | Dianna Lynn Brown | Technician | 21 Old Field Branch Road, Williamson, WV 25661 | 2020-08-14 |
| Find all providers in zip 25661 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1770139719 | Village Network | Clinic/Center | 53 14th St Ste 700, Wheeling, WV 26003-3423 | 2019-08-15 |
| 1982180873 | Wv. Family Support and Rehabilitation Services, Inc. | Clinic/Center | 214 E 8th St, Parkersburg, WV 26101-4615 | 2018-07-14 |
| 1184123705 | Harrison County Commission | Clinic/Center | 215 S 3rd St, Clarksburg, WV 26301-0018 | 2018-02-09 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSON |
| Zip Code | 25661 |
Please comment or provide details below to improve the information on LIGHTHOUSE COMMUNITY INVESTMENT AGENCY INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.