Organization
LIGHTHOUSE COMMUNITY OUTREACH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHELLY KAY BYNUM (EXECUTUVE DIRECTOR)
(323) 401-7600
Entity
Organization
Contact information
Practice address
1968 E 103RD ST, LOS ANGELES, CA 90002-3124
(323) 567-2285
(323) 567-2622
Mailing address
1976 E 103RD ST, LOS ANGELES, CA 90002-3124
(323) 567-2285
(323) 567-2622
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
CA
Other
Enumeration date
05/20/2009
Last updated
05/20/2009
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