NPIMap

Organization Active NPI

New Light Recovery Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Detroit, MI
National Provider Identifier
1134550528
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
821624 Issued in MI
Legal business name
NEW LIGHT RECOVERY CENTER
Practice address
300 W McNichols Rd
Detroit, MI 48203-2703
Phone
(313) 867-8015
Fax
(313) 867-8040
NPI assigned
Dec 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Authorized official

Name
Mr. Marvin Arnold, MS/P, CADC, SST
Title
Program Manager
Phone
(313) 867-8015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 821624 MI Primary

Addresses

Primary practice location

300 W McNichols Rd
Detroit, MI 48203-2703

Mailing address

300 W McNichols Rd
Detroit, MI 48203-2703
Phone (313) 867-8015

Other identifiers 1

IdentifierTypeStateIssuer
1437236940MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
New Light Recovery Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1134550528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482032703",
            "telephone_number": "313-867-8015",
            "fax_number": "313-867-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482032703",
            "telephone_number": "313-867-8015",
            "fax_number": "313-867-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIGHT RECOVERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "ARNOLD",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "313-867-8015",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS/P, CADC, SST"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MI",
            "license": "821624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437236940",
            "state": "MI"
        }
    ],
    "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 Dec 10, 2013; 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.