Provider Demographics
NPI:1053468462
Name:GUIDING LIGHT BEHAVIORAL HEALTH, INC.
Entity Type:Organization
Organization Name:GUIDING LIGHT BEHAVIORAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:LUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-531-2626
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-0368
Mailing Address - Country:US
Mailing Address - Phone:732-531-2626
Mailing Address - Fax:
Practice Address - Street 1:1930 HECK AVE
Practice Address - Street 2:BLDG. 3, SUITE 1
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4476
Practice Address - Country:US
Practice Address - Phone:732-774-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6968309Medicaid