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Organization
MOUNTAIN LIGHT, INC.
Active
Organization
MOUNTAIN LIGHT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP LICHTENBERGER BCBA (CEO)
(805) 443-5859
Entity
Organization
Contact information
Practice address
1396 ROSELAWN AVE, THOUSAND OAKS, CA 91362-2031
(805) 443-5859
Mailing address
2060 E AVENIDA DE LOS ARBOLES # 275D, THOUSAND OAKS, CA 91362-1361
(805) 443-5859
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106H00000X
Marriage & Family Therapist
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/04/2017
Last updated
03/17/2018
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