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General NPI Number Information
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NPI Number | 1942596739
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Entity Type | Organization
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Legal Business Name | GUIDING LIGHT HOME CARE
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Dates
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Enumeration Date | 06/21/2011
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Last Update Date | 06/21/2011
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Provider Practice Location Address
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Address Line | 15332 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-3322
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Country | US
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Telephone | 718-206-2525
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Fax | 718-206-1258
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Provider Business Mailing Address
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Address Line | 15332 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-3322
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Country | US
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Telephone | 718-206-2525
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Fax | 718-206-1258
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | PHILIPPE ESTANISLAS
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Credential |
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Telephone | 718-206-2525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1355L001
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License Number State | NY
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