Organization
LIGHTHOUSE YOUTH SERVICES LLC.
Active
Organization
LIGHTHOUSE YOUTH SERVICES LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKSON CLERVEAU (MANAGING MEMBER)
(863) 840-2408
Entity
Organization
Contact information
Practice address
139 DEER RUN RD, DANVILLE, VA 24540-2863
(863) 840-2408
Mailing address
3261 HUFFINES DR, BURLINGTON, NC 27217-8212
(863) 840-2408
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/29/2026
Last updated
06/29/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up