NPIMap

Organization Active NPI

Salvation Army-Harbor Light

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
National Provider Identifier
1811094998
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
4301061866 Issued in MI
Legal business name
SALVATION ARMY-HARBOR LIGHT
Practice address
3737 Lawton St
Detroit, MI 48208-2500
Phone
(313) 361-6136
Fax
(313) 361-6210
NPI assigned
Sep 20, 2006
Last updated
Oct 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Mrs. Michelle Gates
Title
Qa
Phone
(313) 361-6136

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Recovery Care Clinic/Center 261QR0800X NU
Substance Abuse Rehabilitation Facility 324500000X 4301061866 MI Primary
Respite Care 385H00000X NU

Addresses

Primary practice location

3737 Lawton St
Detroit, MI 48208-2500

Mailing address

3737 Lawton St
Detroit, MI 48208-2500
Phone (313) 361-6136

Other identifiers 1

IdentifierTypeStateIssuer
4701194MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
The Salvation Army Habor Light Onward8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1811094998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 LAWTON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082500",
            "telephone_number": "313-361-6136",
            "fax_number": "313-361-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 LAWTON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082500",
            "telephone_number": "313-361-6136",
            "fax_number": "313-361-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALVATION ARMY-HARBOR LIGHT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "QA",
        "authorized_official_telephone_number": "313-361-6136",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "4301061866",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4701194",
            "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 Oct 10, 2024; 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.