Provider Demographics
NPI:1538794474
Name:GUIDING LIGHT FAMILY SERVICES OF TEXAS, LLC
Entity type:Organization
Organization Name:GUIDING LIGHT FAMILY SERVICES OF TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JADON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-735-5413
Mailing Address - Street 1:413 B ST
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-2515
Mailing Address - Country:US
Mailing Address - Phone:757-735-5413
Mailing Address - Fax:
Practice Address - Street 1:322 RICHLAND DRIVE
Practice Address - Street 2:
Practice Address - City:SUGARLAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:757-735-5413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)