Provider Demographics
NPI:1235477159
Name:LIGHT OF LIFE MINISTRIES, INC.
Entity Type:Organization
Organization Name:LIGHT OF LIFE MINISTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:DR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:SALGADO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-258-6100
Mailing Address - Street 1:913 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15233-1717
Mailing Address - Country:US
Mailing Address - Phone:412-258-6147
Mailing Address - Fax:
Practice Address - Street 1:913 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15233-1717
Practice Address - Country:US
Practice Address - Phone:412-258-6147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-28
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness