Provider Demographics
NPI:1538994223
Name:GUIDING LIGHT FAMILY/YOUTH SERVICES
Entity type:Organization
Organization Name:GUIDING LIGHT FAMILY/YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REVEA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-622-9437
Mailing Address - Street 1:7 QUIET SUNSET CT
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-6875
Mailing Address - Country:US
Mailing Address - Phone:443-622-9437
Mailing Address - Fax:
Practice Address - Street 1:7 QUIET SUNSET CT
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-6875
Practice Address - Country:US
Practice Address - Phone:443-622-9437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEART AND SOUL CATERING SERVICES LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health