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General NPI Number Information
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NPI Number | 1053468462
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Entity Type | Organization
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Legal Business Name | GUIDING LIGHT BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1930 HECK AVE BLDG. 3, SUITE 1
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City | NEPTUNE
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State | NJ
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Zip | 07753-4476
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Country | US
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Telephone | 732-774-0911
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 368
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City | OAKHURST
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State | NJ
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Zip | 07755-0368
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Country | US
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Telephone | 732-531-2626
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Fax |
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Authorized Official
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Title or Position | VP
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Name | MR. HOWARD C LUNDY
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Credential |
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Telephone | 732-531-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | NJ
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