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Organization

MALIBU LIGHTHOUSE TREATMENT CENTERS

Active
Parent organization
MALIBU LIGHTHOUSE TREATMENT CENTERS
Other names
Avalon Ranch
Organization subpart
Yes

Provider details

NPI number
Legal business name
MALIBU LIGHTHOUSE TREATMENT CENTERS
Authorized official
DR. PEGGY LOCKE DC (CLAIMS ADMINISTRATOR)
(805) 488-5159
Entity
Organization

Contact information

Practice address
12517 YERBA BUENA RD, MALIBU, CA 90265-2107
(310) 457-8067
Mailing address
12517 YERBA BUENA RD, MALIBU, CA 90265-2107
(310) 457-8067

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
190612AP
CA

Other

Enumeration date
04/08/2009
Last updated
04/08/2009
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