Organization · Type 2 NPI

The Lighthouse Mentoring Center

Mental Illness Community Based Residential Treatment Facility · Antioch, CA

NPI number 1891361119 Active

Practice location

1925 Garden Ct
Antioch, CA 94509-2865

Call (925) 778-4749 Map

Fax (925) 267-2578

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.

10 other providers at this address

Other mental illness community based residential treatment facility providers in Antioch

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NPI record

NPI: 1891361119
Entity type: Organization (Type 2)
Issued: May 27, 2021
Last updated: Dec 10, 2024
Status: Active
Subpart: Yes of The Lighthouse Mentoring Center 1

Other names

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The Lighthouse Mentoring Center 1 · other name

Authorized official

Quimani Green, LCSW
Head of Service
(925) 778-4749

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About NPI 1891361119

The Lighthouse Mentoring Center's National Provider Identifier is 1891361119, issued on May 27, 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 Dec 10, 2024.