Provider Demographics
NPI:1467755520
Name:LIGHT OF LIFE GLOBAL MINISTRIES
Entity Type:Organization
Organization Name:LIGHT OF LIFE GLOBAL MINISTRIES
Other - Org Name:LIGHT OF LIFE HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:GASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-337-8560
Mailing Address - Street 1:43 GLENWOOD HILL LN
Mailing Address - Street 2:
Mailing Address - City:MILLS RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:28759-4646
Mailing Address - Country:US
Mailing Address - Phone:828-989-0471
Mailing Address - Fax:
Practice Address - Street 1:43 GLENWOOD HILL LN
Practice Address - Street 2:
Practice Address - City:MILLS RIVER
Practice Address - State:NC
Practice Address - Zip Code:28759-4646
Practice Address - Country:US
Practice Address - Phone:828-989-0471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children