BLUE LIGHT INC. (NPI# 1497168215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497168215 |
Entity Type | Organization |
Organization Name | BLUE LIGHT INC. |
Practice Address |
26105 Orchard Lake Rd Suite #208 Farmington Hills MI 48334-4576 |
Practice Telephone | 2486153042 |
Practice Fax Number | 2486153047 |
Mailing Telephone | 2486153042 |
Mailing Fax Number | 2486153047 |
Enumeration Date | 2014-06-09 |
Last Update Date | 2014-06-09 |
Authorized Official Name | MS. PHYLLIS CLARK (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 3139994890 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | 1693530 | 05 |
Street Address |
26105 ORCHARD LAKE RD SUITE #208 |
City | FARMINGTON HILLS |
State | MI |
Zip Code | 48334-4576 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679538300 | Howard Leslie Kahn | Psychologist | 26105 Orchard Lake Rd, Suite 107, Farmington Hills, MI 48334-4576 | 2006-04-18 |
1730729930 | Allison Shapiro Cardew | Psychologist | 26105 Orchard Lake Rd, Farmington Hills, MI 48334-4576 | 2020-01-15 |
1558832204 | Sally Jakeway | Speech-Language Pathologist | 26105 Orchard Lake Rd, Farmington Hills, MI 48334-4576 | 2018-12-06 |
1881178150 | Carmita Jefferson | Counselor | 26105 Orchard Lake Rd, Farmington Hills, MI 48334-4576 | 2018-09-21 |
1851830970 | Timothy Granzotto | Counselor | 26105 Orchard Lake Rd, Suite 309, Farmington Hills, MI 48334-4576 | 2017-02-22 |
1609314947 | Vicki Dandridge | Counselor | 26105 Orchard Lake Rd, 309, Farmington Hills, MI 48334-4576 | 2017-02-07 |
1366995623 | Soul Compass LLC | Psychologist | 26105 Orchard Lake Rd, Suite 207, Farmington Hills, MI 48334-4576 | 2016-08-03 |
1942656277 | Richard Fields | Counselor | 26105 Orchard Lake Rd, 309, Farmington Hills, MI 48334-4576 | 2016-05-05 |
1134590268 | Tiffany Niepokuj | Counselor | 26105 Orchard Lake Rd, Suite 309, Farmington Hills, MI 48334-4576 | 2015-10-15 |
1780080861 | Provider Wellness Group, LLC | Nursing Care | 26105 Orchard Lake Rd, Suite 105, Farmington Hills, MI 48334-4576 | 2014-11-17 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588264535 | Kiah Bradley | Behavior Technician | 2777 Inkster Rd Suite 100, Farmington Hills, MI 48334 | 2020-10-29 |
1417557307 | Carsen D Dresbach | Behavior Technician | 2777 Inster Road Suite 100, Farmington Hills, MI 48334 | 2020-10-29 |
1316560303 | Amy K Pruneau LLC | Psychologist | 26755 Middlebelt Rd Ste 140, Farmington Hills, MI 48334 | 2020-05-25 |
1366089732 | Vian Aljony | Dental Hygienist | 27273 Arden Park Cir, Farmington Hills, MI 48334 | 2019-12-04 |
1699311902 | Sandra Zori | Pharmacist | 27800 Middlebelt Rd, Farmington Hills, MI 48334 | 2019-11-21 |
1902450471 | Kianna Marie Garcia | Behavior Technician | 27777 Inkster Rd., Farmington Hills, MI 48334 | 2019-08-01 |
1619521176 | Samantha Serra | Behavior Technician | 27777 Inkster Rd Suite 100, Farmington Hills, MI 48334 | 2019-08-01 |
1851945398 | Kristen Butler | Behavior Technician | 27777 Inkster Road Suite 100, Farmington Hills, MI 48334 | 2019-08-01 |
1104489038 | Katherine Kalsow | Behavioral Analyst | 27777 Inkster Rd. Suite 100, Farmington Hills, MI 48334 | 2019-04-16 |
1083178487 | Imee Raterta | Physical Therapist | Ability Works Rehab, 28592 Orchard Lake Rd # 300, Farmington Hills, MI 48334 | 2019-01-30 |
Find all providers in zip 48334 |
Taxonomy Code | 261QD1600X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Developmental Disabilities |
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
Notes: [7/1/2003: new] |
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1013087345 | Latino Family Services | Clinic/Center | 3815 W Fort St, Detroit, MI 48216-1652 | 2006-11-08 |
1144830217 | Milestones Aba Therapy | Clinic/Center | 7301 Schaefer Rd, Dearborn, MI 48126-4915 | 2020-08-04 |
1992286306 | Lifelab Kids Foundation | Clinic/Center | 3178 Hilton Rd, Ferndale, MI 48220-1059 | 2018-08-23 |
1407361538 | Residential Opportunities, Inc. | Clinic/Center | 416 Washington St, Three Rivers, MI 49093-1130 | 2017-12-12 |
1730694886 | Residential Opportunities, Inc. | Clinic/Center | 1800 S 35th St, Galesburg, MI 49053-9688 | 2017-12-12 |
1538674676 | Residential Opportunities, Inc. | Clinic/Center | 9616 Portage Rd, Portage, MI 49002-7257 | 2017-12-12 |
1154776201 | Center for Exceptional Families | Clinic/Center | 18501 Rotunda Dr Ste 200, Dearborn, MI 48124-3891 | 2016-04-26 |
Find all providers with the same taxonomy |
City | FARMINGTON HILLS |
Zip Code | 48334 |
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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.