Malibu Lighthouse Treatment Centers

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

190612AP Issued in CA

Legal business name

MALIBU LIGHTHOUSE TREATMENT CENTERS

Doing business as

Avalon Ranch

Practice address

12517 Yerba Buena Rd
Malibu, CA 90265-2107

Phone

(310) 457-8067

NPI assigned

Apr 8, 2009

Organization subpart

Yes

Parent organization

MALIBU LIGHTHOUSE TREATMENT CENTERSAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peggy Locke, DC

Title

Claims Administrator

Phone

(805) 488-5159

Specialties & licenses 1

Addresses

Other names 1

• Avalon Ranch Doing business as

Tax ID family

Malibu Lighthouse Treatment Centers2 organizations share this tax ID, including this one

Part of

Malibu Lighthouse Treatment Centers

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Malibu Lighthouse Treatment Centers

  dba Summit Malibu

  • Substance Abuse Rehabilitation Facility
  • Malibu, CA
  • NPI 1508008582
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1528201498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12517 YERBA BUENA RD",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902652107",
            "telephone_number": "310-457-8067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12517 YERBA BUENA RD",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902652107",
            "telephone_number": "310-457-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALIBU LIGHTHOUSE TREATMENT CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MALIBU LIGHTHOUSE TREATMENT CENTERS",
        "enumeration_date": "2009-04-08",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "LOCKE",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "CLAIMS ADMINISTRATOR",
        "authorized_official_telephone_number": "805-488-5159",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "190612AP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Ranch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Malibu Beach Recovery Center, LLC (RiverMend Health, LLC)
• Malibu Detox, LLC.
• Malibu Hills Treatment Corp
• Malibu Horizon Inc
• Malibu Lighthouse Treatment Centers (Summit Malibu)
• Malibu Medical Corp
• Malibu Medical Corporation
• Malibu Occupational & Speech Therapy
• Malibu Outpatient Inc
• Malibu Renewal Centre

• Substance Abuse Rehabilitation Facility in Malibu, CA
• Providers in Malibu, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.