SALVATION ARMY HARBOR LIGHT (NPI# 1225692619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225692619 |
| Entity Type | Organization |
| Organization Name | SALVATION ARMY HARBOR LIGHT |
| Practice Address |
3737 Lawton St Detroit MI 48208-2500 |
| Practice Telephone | 3133616136 |
| Practice Fax Number | 3133616210 |
| Mailing Telephone | 3133616136 |
| Mailing Fax Number | 3133616210 |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2019-05-01 |
| Authorized Official Name | CYNTHIA MAINVILLE (DIRECTOR) |
| Authorized Official Telephone | 3133616136 |
| Authorized Official Credential | M.ED |
| Is Organization Subpart | Y |
| Parent Organization Name | SALVATION ARMY HARBOR LIGHT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385H00000X | Respite Care | Respite Care Facility |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 0272428 | 05 |
| Other Name | Type Code |
|---|---|
| Medical Respite | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861747578 | Salvation Army Harbor Light | Substance Abuse Rehabilitation Facility | 3250 N Monroe St, Monroe, MI 48162-9297 | 2012-07-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SALVATION ARMY HARBOR LIGHT | 1010 Currie Ave, Minneapolis, MN 55403-1309 |
| System for Award Management (SAM) Entities | SALVATION ARMY HARBOR LIGHT CENTER, THE | 825 N Christiana Ave, Chicago, IL 60651-4110 |
| Street Address |
3737 LAWTON ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48208-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811094998 | Salvation Army-harbor Light | Respite Care | 3737 Lawton St, Detroit, MI 48208-2500 | 2006-09-20 |
| 1487160164 | Tommy Ray Terrell I | Counselor | 3737 Lawton St, Detroit, MI 48208-2500 | 2017-12-18 |
| 1811447436 | Katrina Gail Watkins | Counselor | 3737 Lawton St, Detroit, MI 48208-2500 | 2016-10-06 |
| 1336698950 | Edwin Kurlfink | Counselor | 3737 Lawton St, Salvation Army Harbor Light, Detroit, MI 48208-2500 | 2016-09-23 |
| 1730587205 | Felicia Anderson | Substance Abuse Rehabilitation Facility | 3737 Lawton St, Detroit, MI 48208-2500 | 2014-12-15 |
| 1508272741 | Baiyina Peruzzi | Counselor | 3737 Lawton St, Detroit, MI 48208-2500 | 2014-07-09 |
| 1144634254 | Salvation Army | Substance Abuse Rehabilitation Facility | 3737 Lawton St, Detroit, MI 48208-2500 | 2014-06-17 |
| 1609287655 | The Salvation Army | Substance Abuse Rehabilitation Facility | 3737 Lawton St, Detroit, MI 48208-2500 | 2014-05-13 |
| 1821408105 | Joyce Savage | Counselor | 3737 Lawton St, Detroit, MI 48208-2500 | 2014-05-07 |
| 1083049043 | Toni Cherie Reeves | Counselor | 3737 Lawton St, Detroit, MI 48208-2500 | 2013-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1932645405 | Diane Louise Dodson | Counselor | 5500 Trumbull Apt 315, Detroit, MI 48208 | 2017-01-09 |
| 1164881306 | Cory Eugene Martin | Counselor | 1852 W. Grand Blvd., Detroit, MI 48208 | 2016-02-16 |
| 1578947784 | Hamza Belhaj | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2015-07-17 |
| 1942629167 | Diana Pool | Counselor | 3737 Lawton, Detroit, MI 48208 | 2014-04-15 |
| 1124467048 | Aisha Williams | Social Worker | 4707 Vinewood St., Detroit, MI 48208 | 2013-06-25 |
| 1295079895 | Mia Love | Nurse Practitioner | 2959 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2012-11-20 |
| 1992064356 | Valarie Egeria Foulks | Counselor | 2051 W. Grand Blvd, Detroit, MI 48208 | 2012-05-04 |
| 1023304078 | Ayana Njeri Davis | Massage Therapist | 2550 W. Grand Blvd, Detroit, MI 48208 | 2011-06-28 |
| 1184922627 | Shar Inc. | Community Based Residential Treatment Facility, Mental Illness | 1852 W.grand Blvd, Detroit, MI 48208 | 2011-03-08 |
| Find all providers in zip 48208 | ||||
| Taxonomy Code | 385H00000X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003340266 | Senior's Choice Adult Day Program | Respite Care | 17401 Mack Ave, Detroit, MI 48224-1437 | 2017-04-14 |
| 1710357595 | New Life Counseling and Community Services | Respite Care | 19421 Tireman St, Detroit, MI 48228-3337 | 2015-10-06 |
| 1497006100 | Residential Wellness Group LLC | Respite Care | 16179 Meyers Rd, Detroit, MI 48235-4108 | 2012-09-21 |
| 1891094892 | Blue Leaf Homecare, LLC | Respite Care | 18701 Grand River Ave # 327, Detroit, MI 48223-2214 | 2011-03-16 |
| 1942431424 | Life Changing Crisis & Respite Center | Respite Care | 14301 Longview St, Detroit, MI 48213-1982 | 2009-08-02 |
| 1346485562 | Louisiana Home, Inc. | Respite Care | 1950 Webb Street, Detroit, MI 48206-1282 | 2008-12-03 |
| 1386895878 | Agape Family Caregivers | Respite Care | 633 Burlingame St, Detroit, MI 48202-1004 | 2008-10-02 |
| 1811094998 | Salvation Army-harbor Light | Respite Care | 3737 Lawton St, Detroit, MI 48208-2500 | 2006-09-20 |
| 1386959880 | Franklin Wright Settlements, Inc | Respite Care | 3360 Charlevoix St, Detroit, MI 48207-3220 | 2010-08-10 |
| 1710119375 | Carson Afc, Inc. | Respite Care | 19384 James Couzens Fwy, Detroit, MI 48235-1961 | 2009-08-17 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.