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Light House Group

Emotionally Disturbed Childrens' Residential Treatment Facility in Spring Lake, NC · enumerated 2007 · authorized official Charles Davenport, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1225166069

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Registry record

Entity type Organization (Type 2)
Legal business name Light House Group
Practice address 206 Wapiti Dr, 108 Ashton Pl, Spring Lake, NC, 28390
Phone (910) 497-0299
Fax (910) 497-0297
Enumeration date Mar 2, 2007
Last updated in NPPES Aug 22, 2020

Taxonomy & classification

322D00000X Emotionally Disturbed Childrens' Residential Treatment Facility Residential Treatment Facilities · License MHL -026-805 (NC) Secondary
322D00000X Emotionally Disturbed Childrens' Residential Treatment Facility Residential Treatment Facilities · License MHL-026-782 (NC) Secondary
322D00000X Emotionally Disturbed Childrens' Residential Treatment Facility Residential Treatment Facilities · License MHL-026-627 (NC) Primary

Authorized official

Name Charles Davenport
Title President
Phone (910) 497-0299

Other identifiers

Identifier Type State Issuer
6603194 Medicaid NC -
6603652 Medicaid NC -
6603907 Medicaid NC -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Light House Group?
NPPES lists Charles Davenport (President) as the authorized official for this organization.
What is the NPI number for Light House Group?
The NPI for Light House Group is 1225166069, a Type 2 (organization) record in the CMS NPPES registry.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.