MEDICARE: GUIDELIGHT HEALTH SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1336076017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUIDELIGHT HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	101 FEDERAL ST STE 1900
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02110-1861
Country	:	US
Telephone Number	:	508-761-0903
Fax Number	:

Provider Business Practice Location Address
First Line	:	4150 W PEORIA AVE STE 118
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-3950
Country	:	US
Telephone Number	:	508-761-0903
Fax Number	:

Authorized Official
Title or Position	:	CAO
Name	:	CHARLES SPOSATO
Credential	:
Telephone Number	:	202-415-8497

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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