Provider Demographics
NPI:1114810967
Name:RADIANCE COMMUNITY CARE LLC
Entity type:Organization
Organization Name:RADIANCE COMMUNITY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:
Authorized Official - First Name:GUIFALY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:954-478-2138
Mailing Address - Street 1:297 OAKLAND CIR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-3183
Mailing Address - Country:US
Mailing Address - Phone:954-478-2138
Mailing Address - Fax:434-818-0937
Practice Address - Street 1:297 OAKLAND CIR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-3183
Practice Address - Country:US
Practice Address - Phone:954-478-2138
Practice Address - Fax:434-818-0937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health