Provider Demographics
NPI:1528451788
Name:GUIDING LIGHT SERVICES, INC
Entity type:Organization
Organization Name:GUIDING LIGHT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:T
Authorized Official - Last Name:BRANDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-924-2744
Mailing Address - Street 1:5500 FLORIDA BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-4133
Mailing Address - Country:US
Mailing Address - Phone:225-924-2744
Mailing Address - Fax:225-924-0855
Practice Address - Street 1:5500 FLORIDA BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4133
Practice Address - Country:US
Practice Address - Phone:225-924-2744
Practice Address - Fax:225-924-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203782084315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1560499Medicaid
LA1487827507Medicaid