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The Guardian Light
Mental Illness Community Based Residential Treatment Facility in Glen Allen, Virginia
NPI 1134383102

The Guardian Light is a Mental Illness Community Based Residential Treatment Facility based in Glen Allen, VA. The Guardian Light practices in Glen Allen, VA. The NPI Number for The Guardian Light is 1134383102 and holds a License No. CLO-08-1104074 (Virginia).

The current practice location address for The Guardian Light is 2101 Mountain Run Dr, Glen Allen, VA and can be reached out via phone at 804-475-3344.

Location: 2101 Mountain Run Dr, Glen Allen, VA, 23060-2261
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1134383102
Provider Name
The Guardian Light
Credential
Provider Entity Type
Organization
Address
2101 Mountain Run Dr, Glen Allen, VA, 23060-2261
Phone Number
804-475-3344
Fax Number
Provider Enumeration Date
07/17/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CL0-08-1104074 01 VA LICENSE FROM DEPARTMENT OF SOCIAL SERVICES
CLO-081104074 01 VA LICENSE FROM DEPARTMENT OF SOCIAL SERVICES
institution
Provider Business Practice Location Address Details
Address
2101 Mountain Run Dr
City
Glen Allen
State
Virginia
Zip
23060-2261
Phone Number
804-475-3344
Fax Number
person
Provider Business Mailing Address Details
Address
2101 Mountain Run Dr
City
Glen Allen
State
Virginia
Zip
23060-2261
Phone Number
804-475-3344
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
CLO-08-1104074 (Virginia)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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