Organization · Type 2 NPI

Lighthouse Behavioral Health Center at 1116 E 20th Street LLC

Substance Abuse Rehabilitation Facility · Baltimore, MD

NPI number 1619650116 Active

Practice location

1116 E 20th St
Baltimore, MD 21218-6312

Call (443) 478-0384 Map

Mailing address

1119 E Monument St
Baltimore, MD 21202-4119

Specialties and licenses

Taxonomy	Code	License
Substance Abuse Rehabilitation Facility Primary	324500000X	None listed

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

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NPI record

NPI: 1619650116
Entity type: Organization (Type 2)
Issued: Aug 10, 2023
Last updated: Mar 17, 2026
Status: Active
Subpart: Yes of Lighthouse Behavioral Health Center LLC

Other names

dba Sud Res at 1116 E 20th Street · doing business as
Lighthouse Behavioral Health Center at 1116 E 20th Street · doing business as

Authorized official

Vernon Holmes
CEO
(443) 320-2696

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1619650116

Lighthouse Behavioral Health Center at 1116 E 20th Street LLC's National Provider Identifier is 1619650116, issued on Aug 10, 2023. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Baltimore, MD. The record was last updated on Mar 17, 2026.