Active NPI
Light of Recovery Inc
- Mental Illness Community Based Residential Treatment Facility
- Detroit, MI
National Provider Identifier
1891988937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- License
- 6801015887
- Legal business name
- LIGHT OF RECOVERY INC
- Practice address
- 2008 W Grand Blvd
Detroit, MI 48208-1021 - Phone
- (313) 898-5938
- NPI assigned
- Aug 22, 2007
- Last updated
- Jul 2, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Servilla Harris
- Title
- Social Worker
- Phone
- (313) 898-5938
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | 6801015887 | MI | Primary |
Addresses
Primary practice location
2008 W Grand Blvd
Detroit, MI 48208-1021
Mailing address
2008 W Grand Blvd
Detroit, MI 48208-1021
National Provider Directory
National Provider DirectoryLocations
2008 W Grand Blvd
Detroit, MI 48208
Phone (313) 898-3928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187740800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1372723200000",
"number": "1891988937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2008 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482081021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2008 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482081021",
"telephone_number": "313-898-5938"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIGHT OF RECOVERY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-22",
"last_updated": "2013-07-02",
"status": "A",
"authorized_official_last_name": "HARRIS",
"authorized_official_first_name": "SERVILLA",
"authorized_official_title_or_position": "SOCIAL WORKER",
"authorized_official_telephone_number": "313-898-5938"
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "MI",
"license": "6801015887",
"primary": true
}
],
"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 Jul 2, 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.