Provider Demographics
NPI:1124586698
Name:RAY OF LIGHT HOME SERVICES INC.
Entity Type:Organization
Organization Name:RAY OF LIGHT HOME SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUSLEYDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:IBANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN/RRT
Authorized Official - Phone:786-238-7969
Mailing Address - Street 1:1920 NW 107TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-3814
Mailing Address - Country:US
Mailing Address - Phone:786-238-7969
Mailing Address - Fax:305-400-2430
Practice Address - Street 1:1920 NW 107TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33167-3814
Practice Address - Country:US
Practice Address - Phone:786-238-7969
Practice Address - Fax:305-400-2430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health