# THE LIGHTHOUSE-HOME FOR MEDICALLY FRAGILE CHILDREN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Century Lighthouse Recovery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639668114
- **Authorized official:** LISA CARMELLA AMOS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (310) 904-4645

## Contact information

- **Practice address:** 206 W CENTURY BLVD, LOS ANGELES, CA 90003-4502
- **Practice address phone:** (310) 904-4645
- **Mailing address:** 30845 BURNING TREE DR, CANYON LAKE, CA 92587-7503
- **Mailing address phone:** (310) 904-4645

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0800X | Recovery Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/09/2018
- **Last updated:** 05/09/2018