NPIMap

Organization Active NPI

Lakeridge Village, Inc.

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
National Provider Identifier
1144469461
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
822985 Issued in MI
Legal business name
LAKERIDGE VILLAGE, INC.
Practice address
15941 Fairfield St
Detroit, MI 48238-4123
Phone
(313) 345-4310
Fax
(313) 345-4315
NPI assigned
Feb 10, 2009
Last updated
Jan 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Authorized official

Name
Eugenia HolimonNPI 1548886732
Title
Chief of Staff
Phone
(313) 340-2808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Voluntary or Charitable Agency 251V00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Substance Abuse Rehabilitation Facility 324500000X 822985 MI Primary
Non-emergency Medical Transport (VAN) 343900000X NU
Lodging Provider 177F00000X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

15941 Fairfield St
Detroit, MI 48238-4123

Mailing address

15025 Fenkell St
Detroit, MI 48227-2647
Phone (313) 345-4310

Other practice location 1

15025 Fenkell St
Detroit, MI 48227-2647
Phone (313) 345-4310

National Provider Directory

National Provider Directory

Locations

15025 Fenkell St
Detroit, MI 48227
Phone (313) 340-2809

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1234224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769385600000",
    "number": "1144469461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15025 FENKELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482272647",
            "telephone_number": "313-345-4310",
            "fax_number": "313-345-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15941 FAIRFIELD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482384123",
            "telephone_number": "313-345-4310",
            "fax_number": "313-345-4315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15025 Fenkell St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482272647",
            "country_code": "US",
            "telephone_number": "313-345-4310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKERIDGE VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-10",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A",
        "authorized_official_last_name": "HOLIMON",
        "authorized_official_first_name": "EUGENIA",
        "authorized_official_title_or_position": "CHIEF OF STAFF",
        "authorized_official_telephone_number": "313-340-2808"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "822985",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jan 26, 2026; 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.