Personalized Nursing Light House Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

SA0821032 Issued in MI

Legal business name

PERSONALIZED NURSING LIGHT HOUSE INC

Practice address

7752 N Canton Center Rd Ste 120
Canton, MI 48187

Phone

(734) 851-7311

Fax

(734) 851-7312

NPI assigned

Jul 17, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Paliwoda

Title

Ceo

Phone

(810) 231-3839

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Personalized Nursing LIGHT House Inc Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Cavins

  • Addiction (Substance Use Disorder) Counselor
  • Canton, MI
  • NPI 1851934418
  NPD (past)

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1285110767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7752 N CANTON CENTER RD STE 120",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871328",
            "telephone_number": "734-851-7311",
            "fax_number": "734-851-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7752 N CANTON CENTER RD STE 120",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "48187",
            "telephone_number": "734-851-7311",
            "fax_number": "734-851-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED NURSING LIGHT HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "PALIWODA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "810-231-3839",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "SA0821032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "382942874",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Personalized Nursing LIGHT House Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Pediatric Dentistry
• Hailey Penzak, M.S., TLLP
• Latoya Lynn Peoples-Shackelford, LPC
• Natalie Brohl Perelli, PH.D.
• Dulce Catalina Perry
• Mamta V Peter
• Vinod Surendrakumar Peter, RPT
• Latrice Peterson
• Sofia Petix
• Debra Petties

• Substance Abuse Rehabilitation Facility in Canton, MI
• Providers in Canton, MI by specialty
• Substance Abuse Rehabilitation Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.