Provider Demographics
NPI:1093133274
Name:GUIDING LIGHT PCA SERVICES
Entity Type:Organization
Organization Name:GUIDING LIGHT PCA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LASHAWNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-993-0062
Mailing Address - Street 1:5700 FLORIDA BLVD
Mailing Address - Street 2:STE 1210
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-4274
Mailing Address - Country:US
Mailing Address - Phone:855-330-4920
Mailing Address - Fax:337-264-7168
Practice Address - Street 1:5700 FLORIDA BLVD
Practice Address - Street 2:STE 1210
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4274
Practice Address - Country:US
Practice Address - Phone:855-330-4920
Practice Address - Fax:337-264-7168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care