The Lighthouse-Home for Medically Fragile Children

Primary specialty

Recovery Care Clinic/CenterTaxonomy code 261QR0800X

Legal business name

THE LIGHTHOUSE-HOME FOR MEDICALLY FRAGILE CHILDREN

Doing business as

Century Lighthouse Recovery

Practice address

206 W Century Blvd
Los Angeles, CA 90003-4502

Phone

(310) 904-4645

NPI assigned

May 9, 2018

Organization subpart

No

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

Authorized official

Name

Lisa Carmella Amos

Title

Executive Director

Phone

(310) 904-4645

Specialties & licenses 1

Addresses

Other names 1

• Century Lighthouse Recovery Doing business as

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1639668114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30845 BURNING TREE DR",
            "city": "CANYON LAKE",
            "state": "CA",
            "postal_code": "925877503",
            "telephone_number": "310-904-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W CENTURY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900034502",
            "telephone_number": "310-904-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LIGHTHOUSE-HOME FOR MEDICALLY FRAGILE CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "AMOS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "CARMELLA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "310-904-4645"
    },
    "taxonomies": [
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Century Lighthouse Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Recovery Care Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Recovery Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; 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.