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Organization

THE LIGHTHOUSE-HOME FOR MEDICALLY FRAGILE CHILDREN

Active
Other names
Century Lighthouse Recovery
Organization subpart
No

Provider details

NPI number
Authorized official
LISA CARMELLA AMOS (EXECUTIVE DIRECTOR)
(310) 904-4645
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary

Other

Enumeration date
05/09/2018
Last updated
05/09/2018
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