Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Light House Group

Organization Emotionally Disturbed Childrens' Residential Treatment Facility · NPI 1225166069

Light House Group is an Emotionally Disturbed Childrens' Residential Treatment Facility in Spring Lake, North Carolina. Licensed in North Carolina. Registered with an NPI since 2007.

Licensed in
NC
In the registry since
2007
Specialties on file
3

Practice location Address checks out

206 Wapiti Dr 108 Ashton Pl
Spring Lake, NC 28390-1530
Phone: (910) 497-0299
Fax: (910) 497-0297
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emotionally Disturbed Childrens' Residential Treatment Facility (primary) Taxonomy 322D00000X · Licence MHL-026-627 (NC)
Emotionally Disturbed Childrens' Residential Treatment Facility Taxonomy 322D00000X · Licence MHL -026-805 (NC)
Emotionally Disturbed Childrens' Residential Treatment Facility Taxonomy 322D00000X · Licence MHL-026-782 (NC)

Record details

NPI number1225166069
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Davenport — President · (910) 497-0299
NPI enumeratedMarch 2, 2007
Last updated in NPPESAugust 22, 2020
Mailing address408 Harrell St, Po Box 1089, Spring Lake, NC 28390-3607

Other providers in Spring Lake