Provider Demographics
NPI:1972317105
Name:GUIDELIGHT HEALTH OF MASSACHUSETTS, LLC
Entity type:Organization
Organization Name:GUIDELIGHT HEALTH OF MASSACHUSETTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:SPOSATO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-249-3557
Mailing Address - Street 1:2300 CROWN COLONY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-0990
Mailing Address - Country:US
Mailing Address - Phone:617-307-2560
Mailing Address - Fax:617-801-8195
Practice Address - Street 1:2300 CROWN COLONY DR STE 200
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-0990
Practice Address - Country:US
Practice Address - Phone:617-307-2560
Practice Address - Fax:617-801-8195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health