Organization · Type 2 NPI

Malibu Lighthouse Treatment Centers

Substance Abuse Rehabilitation Facility · Malibu, CA

NPI number 1528201498 Active

Practice location

12517 Yerba Buena Rd
Malibu, CA 90265-2107

Specialties and licenses

Taxonomy	Code	License
Substance Abuse Rehabilitation Facility Primary	324500000X	190612AP (CA)

Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Other substance abuse rehabilitation facility providers in Malibu

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NPI record

NPI: 1528201498
Entity type: Organization (Type 2)
Issued: Apr 8, 2009
Last updated: Apr 8, 2009
Status: Active
Subpart: Yes of Malibu Lighthouse Treatment Centers

Other names

<unavail>
Avalon Ranch · doing business as

Authorized official

Dr. Peggy Locke, DC
Claims Administrator
(805) 488-5159

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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 1528201498

Malibu Lighthouse Treatment Centers's National Provider Identifier is 1528201498, issued on Apr 8, 2009. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Malibu, CA. The record was last updated on Apr 8, 2009.