Organization
GUIDING LIGHT YOUTH AND FAMILY SERVICES
Active
Other names
Polkton Road
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE TOWLER III (DIRECTOR)
(704) 684-0257
Entity
Organization
Contact information
Practice address
1233 MORNINGSIDE MEADOW LN, MATTHEWS, NC 28104-8553
(704) 684-0257
(704) 684-0258
Mailing address
7931 ANSONVILLE POLKTON RD, POLKTON, NC 28135-9336
(704) 684-0257
(704) 684-0258
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8300505
—
NC
05
—
8300505B
—
NC
05
—
8300505G
—
NC
Enumeration date
01/31/2007
Last updated
08/15/2007
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