Organization · Type 2 NPI

Lighthouse Behavioral Health Center at 1114 E 20th Street LLC

Substance Abuse Rehabilitation Facility · Baltimore, MD

NPI number 1740963248 Active

Practice location

1114 E 20th St
Baltimore, MD 21218-6312

Call (443) 708-5056 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: 1740963248
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

Lighthouse Behavioral Health Center at 1114 E 20th Street · doing business as
Sud Res at 1114 E 20th Street · doing business as

Authorized official

Vernon Holmes
CEO
(443) 320-2706

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About NPI 1740963248

Lighthouse Behavioral Health Center at 1114 E 20th Street LLC's National Provider Identifier is 1740963248, 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.