Organization Active NPI

Guiding Light Sober Living

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
National Provider Identifier
1679803464
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
GUIDING LIGHT SOBER LIVING
Practice address
2409 Calvert St
Detroit, MI 48206-1533
Phone
(313) 869-6905
Fax
(313) 883-6159
NPI assigned
Dec 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Darryl Dewberry, MSW
Title
Ceo
Phone
(313) 869-6905

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X MI
Substance Abuse Rehabilitation Facility 324500000X MI Primary

Addresses

Primary practice location

2409 Calvert St
Detroit, MI 48206-1533

Mailing address

2409 Calvert St
Detroit, MI 48206-1533
Phone (313) 869-6905

National Provider Directory

National Provider Directory
Tax ID family
Guiding Light Sober Living2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2409 Calvert St
Detroit, MI 48206
Phone (313) 869-6905

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679803464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 CALVERT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061533",
            "telephone_number": "313-869-6905",
            "fax_number": "313-883-6159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 CALVERT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061533",
            "telephone_number": "313-869-6905",
            "fax_number": "313-883-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUIDING LIGHT SOBER LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DEWBERRY",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-869-6905",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.