| Lighthouse Mentoring Center | |
|
2213 Buchanan Rd # R107 Antioch CA 94509-4265 | |
| (925) 529-4885 | |
| Not Available |
| Full Name | Lighthouse Mentoring Center |
|---|---|
| Speciality | Social Worker |
| Location | 2213 Buchanan Rd # R107, Antioch, California |
| Authorized Official Name and Position | Phyllis Ritter (CLINICAL DIRECTOR) |
| Authorized Official Contact | 9256281641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Mentoring Center 2213 Buchanan Rd Ste 107 Antioch CA 94509-4265 Ph: (925) 628-1641 | Lighthouse Mentoring Center 2213 Buchanan Rd # R107 Antioch CA 94509-4265 Ph: (925) 529-4885 |
| NPI Number | 1750104881 |
|---|---|
| Provider Enumeration Date | 11/06/2024 |
| Last Update Date | 11/06/2024 |
| Certification Date | 11/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750104881 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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