Provider Demographics
NPI:1821635327
Name:GUIDING LIGHT ASSISTED LIVING RETIREMENT HOME CARE LLC
Entity Type:Organization
Organization Name:GUIDING LIGHT ASSISTED LIVING RETIREMENT HOME CARE LLC
Other - Org Name:GUIDING LIGHT HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-631-2132
Mailing Address - Street 1:125 NW 109TH AVE APT 107
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-5116
Mailing Address - Country:US
Mailing Address - Phone:561-631-2132
Mailing Address - Fax:407-369-4659
Practice Address - Street 1:125 NW 109TH AVE APT 107
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-5116
Practice Address - Country:US
Practice Address - Phone:561-631-2132
Practice Address - Fax:407-369-4659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care