Organization Active NPI

Light of Recovery Inc

  • Mental Illness Community Based Residential Treatment Facility
  • Detroit, MI
National Provider Identifier
1891988937
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
6801015887 Issued in MI
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, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

Verify at the official NPI Registry.