THE LIGHTHOUSE - TRAVERSE CITY, LLC (NPI# 1740369446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740369446 |
| Entity Type | Organization |
| Organization Name | THE LIGHTHOUSE - TRAVERSE CITY, LLC |
| Practice Address |
4140 Beacon St Kingsley MI 49649 |
| Mailing Address |
Po Box 289 1655 E Caro Rd Caro MI 48723-0289 |
| Practice Telephone | 2312631350 |
| Practice Fax Number | 2312631353 |
| Mailing Telephone | 9896732500 |
| Mailing Fax Number | 9896733356 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARK WILSON (DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 9896732500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649359316 | The Lighthouse - Traverse City, LLC | Custodial Care Facility | 4140 Beacon St, Kingsley, MI 49649 | 2006-11-03 |
| Street Address |
4140 BEACON ST |
| City | KINGSLEY |
| State | MI |
| Zip Code | 49649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649359316 | The Lighthouse - Traverse City, LLC | Custodial Care Facility | 4140 Beacon St, Kingsley, MI 49649 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346742053 | Carlene Brown | Physical Therapist | 850 Brewster Trl, Kingsley, MI 49649 | 2018-03-08 |
| 1063926756 | Cheryl Sue Dann | Social Worker | 2283 M-113 E, Kingsley, MI 49649 | 2017-11-17 |
| 1386168854 | Lori Rachelle Metcalf-rodes | Counselor | 5081 Walton Road, Kingsley, MI 49649 | 2017-07-27 |
| 1356891865 | David Erik Richard Burke | Dentist | 116 W Main St., Kingsley, MI 49649 | 2016-10-07 |
| 1366766081 | Kimberly Anne Michels | Nurse Practitioner | 112 S. Brownson Ave, Kingsley, MI 49649 | 2010-03-24 |
| 1528382538 | Grand Traverse County Health Department | Clinic/Center | 112 S Brownson Ave, Kingsley, MI 49649 | 2010-03-19 |
| 1477739571 | Rnc Medical Supplies | Durable Medical Equipment & Medical Supplies | 9437 Church St, Kingsley, MI 49649 | 2008-01-18 |
| 1568842052 | Anna Cox | Registered Nurse | 2283 E M 113, Kingsley, MI 49649 | 2015-06-01 |
| 1558381509 | Michael Zaleski | Pharmacist | 114 S. Brownson Ave, Kingsley, MI 49649-0247 | 2006-07-20 |
| 1225058449 | Kingsley Pharmaceuticals Inc. | Durable Medical Equipment & Medical Supplies | 118 S Brownson Ave, Kingsley, MI 49649-0367 | 2006-07-20 |
| Find all providers in zip 49649 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285257287 | Genesis Eldercare Rehabilitation Services LLC | Clinic/Center | 5858 S 47 Rd, Cadillac, MI 49601-9508 | 2020-05-26 |
| 1538790241 | Genesis Eldercare Rehabilitation Services LLC | Clinic/Center | 2325 Rockwell Dr, Midland, MI 48642-9325 | 2020-01-31 |
| 1386295210 | Novacare Outpatient Rehabilitation East, Inc. | Clinic/Center | 641 W 9 Mile Rd Ste D, Ferndale, MI 48220-1779 | 2019-09-23 |
| 1013566199 | J.l Hunt Therapeutics | Clinic/Center | 43700 Woodward Ave Ste 108, Bloomfield Hills, MI 48302-5060 | 2019-09-10 |
| 1548828502 | Chsc Inc | Clinic/Center | 10125 W 8 Mile Rd, Detroit, MI 48221-1004 | 2019-06-04 |
| 1427521723 | Genesis Eldercare Rehabilitation Services LLC | Clinic/Center | 3951 W Milham Ave, Portage, MI 49024-1088 | 2019-01-09 |
| 1366934184 | Rehabcare Group East, LLC | Clinic/Center | 1300 N Telegraph Rd, Dearborn, MI 48128-1204 | 2018-06-06 |
| 1902305048 | Nrmi, LLC | Clinic/Center | 14461 E 11 Mile Rd, Warren, MI 48088-4886 | 2018-02-05 |
| 1194230888 | Blue Water Speech Therapy | Clinic/Center | 7950 Caberfae Trl, Clarkston, MI 48348-3707 | 2017-12-05 |
| 1093236291 | Genesis Eldercare Rehabilitation Services LLC | Clinic/Center | 1620 S Mission St Ste O, Mt Pleasant, MI 48858-4466 | 2017-06-28 |
| Find all providers with the same taxonomy | ||||
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| 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.