Organization Name: | THE GUARDIAN LIGHT |
NPI Number: | 1134383102 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JANICE MARIE BAILEY (ADMINISTRATOR) |
Mailing Address: | 2101 Mountain Run Dr Glen Allen |
State: | VA US |
Postal Code: | 230602261 |
Phone Number: | 8044753344 |
Fax Number: | |
NPI Enumeration Date: | 07/17/2008 |
NPI Last Update Date: | 07/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | CLO-08-1104074 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |