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General NPI Number Information
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NPI Number | 1821951112
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE TREATMENT INC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1243 W PEARL ST
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City | ANAHEIM
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State | CA
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Zip | 92801-5936
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Country | US
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Telephone | 714-780-1174
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Fax | 714-844-4810
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Provider Business Mailing Address
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Address Line | 1320 W PEARL ST
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City | ANAHEIM
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State | CA
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Zip | 92801-5941
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Country | US
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Telephone | 714-780-1174
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Fax | 714-844-4810
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Authorized Official
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Title or Position | COMPLIANCE MANAGER
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Name | MRS. ELIZABETH GJONOVICH
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Credential |
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Telephone | 949-836-4432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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