Healthcare Provider Details

I. General information

NPI: 1801681861
Provider Name (Legal Business Name): GUIDING LIGHT HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12021 PARKSIDE VISTA LN
LOUISVILLE KY
40229-6517
US

IV. Provider business mailing address

12021 PARKSIDE VISTA LN
LOUISVILLE KY
40229-6517
US

V. Phone/Fax

Practice location:
  • Phone: 502-671-5565
  • Fax:
Mailing address:
  • Phone: 502-671-5565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: AJI NDUMBEH MBYE
Title or Position: OWNER
Credential:
Phone: 347-301-2734