Provider Demographics
NPI:1801992474
Name:RAY OF LIGHT HOMES, LLC.
Entity type:Organization
Organization Name:RAY OF LIGHT HOMES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR COOWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:ROBIN
Authorized Official - Last Name:BERKBIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:BA, QP, DCS
Authorized Official - Phone:828-281-9998
Mailing Address - Street 1:PO BOX 1497
Mailing Address - Street 2:
Mailing Address - City:LEICESTER
Mailing Address - State:NC
Mailing Address - Zip Code:28748-1497
Mailing Address - Country:US
Mailing Address - Phone:828-281-9998
Mailing Address - Fax:828-281-9092
Practice Address - Street 1:70 WOODFIN PL
Practice Address - Street 2:SUITE 329
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2463
Practice Address - Country:US
Practice Address - Phone:828-281-9998
Practice Address - Fax:828-281-9092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409313Medicaid