Organization · Type 2 NPI

The Lighthouse Mentoring Center

Mental Illness Community Based Residential Treatment Facility · Antioch, CA

NPI number 1386219954 Active

Practice location

4343 Buckskin Dr
Antioch, CA 94531-7470

Call (925) 706-7270 Map

Fax (925) 706-7268

Mailing address

PO Box 853
Pittsburg, CA 94565-0085

Specialties and licenses

Taxonomy	Code	License
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	None listed

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Another provider at this address

Phyllis A. RitterMarriage & Family Therapist Antioch, CA NPI 1629642020

Other mental illness community based residential treatment facility providers in Antioch

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NPI record

NPI: 1386219954
Entity type: Organization (Type 2)
Issued: May 25, 2021
Last updated: Jun 3, 2022
Status: Active
Subpart: Yes of The Lighthouse Mentoring Center

Other names

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Lighthouse Mentoring Center 4 · other name

Authorized official

Phyllis A Ritter, LMFT
Clinical Director
(922) 628-1641

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1386219954

The Lighthouse Mentoring Center's National Provider Identifier is 1386219954, issued on May 25, 2021. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Antioch, CA. The record was last updated on Jun 3, 2022.