LUMINESCENCE CENTER OF MICHIGAN LLC (NPI# 1952856650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952856650 |
| Entity Type | Organization |
| Organization Name | LUMINESCENCE CENTER OF MICHIGAN LLC |
| Practice Address |
16085 Dix Toledo Rd Southgate MI 48195-2950 |
| Practice Telephone | 7344764849 |
| Mailing Telephone | 7344764849 |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2016-08-23 |
| Authorized Official Name | NOURA ABDULKADER (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 7344764849 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
| Street Address |
16085 DIX TOLEDO RD |
| City | SOUTHGATE |
| State | MI |
| Zip Code | 48195-2950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1285102368 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 16256 Fort St, Southgate, MI 48195 | 2018-11-07 |
| 1003382979 | Saran Charisse Watts | Case Manager/Care Coordinator | 31101 Allen Rd, Building 5, Southgate, MI 48195 | 2018-10-18 |
| 1255824025 | Kiesta Janell Lindsey | Social Worker | 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 | 2018-06-07 |
| 1417473224 | Suzette Michele Watson | Nurse Practitioner | 14319 Dix-toledo, Southgate, MI 48195 | 2017-08-15 |
| 1275069486 | Liza Du Plessis | Student in an Organized Health Care Education/Training Program | 13111 Allen Road, Southgate, MI 48195 | 2017-05-08 |
| 1497290456 | Beaumont Health | Clinic/Center | 15777 Northline, Southgate, MI 48195 | 2016-12-30 |
| 1184172876 | Felicia Wilson | Licensed Practical Nurse | 15771 Wildemere, Southgate, MI 48195 | 2016-09-12 |
| 1225487978 | Stacey Petrick-strickland | Technician, Other | 12189 Agnes, Southgate, MI 48195 | 2016-06-03 |
| 1205298486 | Ashley Francis | Hearing Instrument Specialist | 18800 Eureka Rd., Southgate, MICHIGAN 48195 | 2016-03-25 |
| Find all providers in zip 48195 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871099481 | Baymark of Michigan, Inc. | Clinic/Center | 5500 Division Avenue Se, Kentwood, MI 49548 | 2018-04-03 |
| 1952827107 | Nupoint Services LLC | Clinic/Center | 1620 44th Street Se, Grand Rapids, MI 49508 | 2017-08-19 |
| 1881118206 | Harrison Udensi Igwe | Clinic/Center | 522 South Maple Stree, Ann Arbor, MI 48103 | 2017-07-27 |
| 1942675426 | Eastern Clinic Pllc | Clinic/Center | 1555 Eastern Ave Se, Grand Rapids, MI 49507-2055 | 2015-12-09 |
| 1740653641 | Ann Arbor Treatment Services, LLC | Clinic/Center | 4673 Washtenaw Ave, Ann Arbor, MI 48108 | 2015-11-02 |
| 1902284193 | Therapeutics, LLC | Clinic/Center | 50222 Dennis Ct, Wixom, MI 48393-2023 | 2015-05-08 |
| 1578960480 | Changes1, Pllc | Clinic/Center | 19940 Conant, Ste A, B, & C, Detroit, MI 48234-1494 | 2014-11-21 |
| 1669874418 | The Brighton Center, Inc. | Clinic/Center | 2512 Harte Dr, Brighton, MI 48114-7002 | 2014-09-24 |
| 1275969990 | Harriet Alexander | Clinic/Center | 20724 Eureka Rd., Taylor, MI 48180 | 2013-09-26 |
| 1922383397 | Rainbow Center Inc. | Clinic/Center | 20724 Eureka Rd, Taylor, MI 48180-5313 | 2011-10-18 |
| Find all providers with the same taxonomy | ||||
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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.