MEDICARE: GUIDING LIGHT INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811039720
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUIDING LIGHT INC

Provider Business Mailing Address
First Line	:	PO BOX 42308
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28215-0006
Country	:	US
Telephone Number	:	704-361-1999
Fax Number	:	704-409-4877

Provider Business Practice Location Address
First Line	:	1205 N PINE ST
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-4711
Country	:	US
Telephone Number	:	910-738-4095
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. SHELVIN AUNDRA RICE
Credential	:
Telephone Number	:	704-361-1999

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	08/10/2007

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Directions to “GUIDING LIGHT INC ” Practice Location

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