Organization
LIGHT AND GLORY LLC
Active
Organization
LIGHT AND GLORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALDINE RICAFORTE RN (PROGRAM DIRECTOR)
(757) 215-6953
Entity
Organization
Contact information
Practice address
1513 MALLORY CT, VIRGINIA BEACH, VA 23464-6419
(757) 215-6953
(757) 467-3604
Mailing address
1513 MALLORY CT, VIRGINIA BEACH, VA 23464-6419
(757) 215-6953
(757) 467-3604
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
01/13/2020
Last updated
01/13/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up