Provider Demographics
NPI:1083166268
Name:GUIDING LIGHT FOUNDATION, INC
Entity Type:Organization
Organization Name:GUIDING LIGHT FOUNDATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FLORE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-843-1982
Mailing Address - Street 1:22482 SW 56TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22482 SW 56TH AVE
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-4604
Practice Address - Country:US
Practice Address - Phone:561-843-1982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health