Provider Demographics
NPI:1518273861
Name:GUIDING LIGHT YOUTH AND FAMILY SERVICES
Entity Type:Organization
Organization Name:GUIDING LIGHT YOUTH AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MOSLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:706-691-2233
Mailing Address - Street 1:2 MOSLEY DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:SC
Mailing Address - Zip Code:29847-2608
Mailing Address - Country:US
Mailing Address - Phone:706-691-2233
Mailing Address - Fax:
Practice Address - Street 1:2 MOSLEY DR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:SC
Practice Address - Zip Code:29847-2608
Practice Address - Country:US
Practice Address - Phone:706-691-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health