PERSONALIZED NURSING LIGHT HOUSE INC (NPI# 1285110767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285110767 |
| Entity Type | Organization |
| Organization Name | PERSONALIZED NURSING LIGHT HOUSE INC |
| Other Organization Name | PERSONALIZED NURSING LIGHT HOUSE INC |
| Practice Address |
7752 N Canton Center Rd Ste 120 Canton MI 48187 |
| Mailing Address |
7752 N Canton Center Rd Ste 120 Canton MI 48187-1328 |
| Practice Telephone | 7348517311 |
| Practice Fax Number | 7348517312 |
| Mailing Telephone | 7348517311 |
| Mailing Fax Number | 7348517312 |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-18 |
| Authorized Official Name | MR. JOSEPH PALIWODA (CEO) |
| Authorized Official Telephone | 8102313839 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | SA0821032 | MI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | IRS | 382942874 | 01 |
| Other Name | Type Code |
|---|---|
| Personalized Nursing LIGHT House Inc | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740670512 | Personalized Nursing Light House Inc | Substance Abuse Rehabilitation Facility | 30671 Stephenson Hwy, Madison Heights, MI 48071-1635 | 2015-01-30 |
| 1346684420 | Personalized Nursing Light House Inc | PACE Provider Organization | 23133 Orchard Lake Rd, Ste 203, Farmington Hills, MI 48336-3268 | 2013-04-19 |
| Street Address |
7752 N CANTON CENTER RD STE 120 |
| City | CANTON |
| State | MI |
| Zip Code | 48187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851934418 | Matthew Cavins | Counselor | 7752 N Canton Center Rd Ste 120, Canton, MI 48187-1328 | 2019-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114547874 | Savannah Dugan | Occupational Therapist | 5969 N Canton Center Rd, Canton, MI 48187 | 2020-04-23 |
| 1225674823 | Cura Professional Group | Home Health | 1638 East Lakeview Lane, Canton, MI 48187 | 2019-11-19 |
| 1740825207 | Vlp Can LLC | Dentist | 39883 Ford Rd., Canton, MI 48187 | 2019-11-08 |
| 1487112942 | Michigan Dialysis Services, LLC | Clinic/Center | 275 N Canton Center Rd, Canton, MI 48187 | 2019-03-04 |
| 1447734496 | Integrated Health Pharmacy LLC | Pharmacy | 49650 Cherry Hill Rd., Canton, MI 48187 | 2018-09-16 |
| 1285117499 | Susan Rhoton | Licensed Vocational Nurse | 6223 N Canton, Suite 201, Canton, MI 48187 | 2018-09-13 |
| 1083111793 | Heydie Alejandra Orr | Social Worker | 5840 N Canton Center Rd Ste 221, Canton, MI 48187 | 2018-04-09 |
| 1285139204 | Chawla Enterprises Inc | Durable Medical Equipment & Medical Supplies | 5840 N Canton Center Rd Ste 222, Canton, MI 48187 | 2018-03-30 |
| 1689192221 | Arcturus Pllc | Physical Therapist | 5820 Lilley Rd. Suite 6, Canton, MI 48187 | 2017-09-04 |
| 1871023523 | Metroway Transportation LLC | Non-emergency Medical Transport (VAN) | 2200 N. Canton Center, Ste. 200a, Canton, MI 48187 | 2017-06-15 |
| Find all providers in zip 48187 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275069502 | Kurt Davey | Substance Abuse Rehabilitation Facility | 43419 W Arbor Way Dr, Unit 190, Canton, MI 48188-4809 | 2017-05-05 |
| 1346584984 | Quest Recovery and Prevention Services | Substance Abuse Rehabilitation Facility | 1711 Spring Avenue Nw, Canton, OH 44714 | 2012-11-20 |
| 1922320894 | Sarah Jane Chew | Substance Abuse Rehabilitation Facility | 8142 Honeytree Blvd, Canton, MI 48187-4109 | 2010-02-19 |
| 1225173263 | Sundown Ranch, Inc. | Substance Abuse Rehabilitation Facility | 3120 Vzcr 2318, Canton, TX 75103 | 2007-02-20 |
| 1710936901 | Quest Recovery and Prevention Services | Substance Abuse Rehabilitation Facility | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2006-05-08 |
| 1104885649 | Bowling Green Inn of South Dakota | Substance Abuse Rehabilitation Facility | 1010 E 2nd St, Canton, SD 57013-1905 | 2006-03-22 |
| 1891332193 | Bedrock Rehab, LLC | Substance Abuse Rehabilitation Facility | 1 Meadowbrook Way, Canton, MA 02021-2496 | 2019-12-05 |
| 1821536723 | Angela Lynn Stewart | Substance Abuse Rehabilitation Facility | 43825 Michigan Ave, Canton, MI 48188-2551 | 2017-02-10 |
| 1154677896 | Bowling Green Inn of South Dakota | Substance Abuse Rehabilitation Facility | 1010 E 2nd St, Canton, SD 57013-1905 | 2012-07-31 |
| 1982961116 | Donna A Hatcher | Substance Abuse Rehabilitation Facility | 1711 Spring Ave Ne, Canton, OH 44714-2349 | 2012-04-12 |
| Find all providers in CANTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.