LIGHT OF HOPE FAMILY MEDICAL CLINIC (NPI# 1497172381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497172381 |
| Entity Type | Organization |
| Organization Name | LIGHT OF HOPE FAMILY MEDICAL CLINIC |
| Practice Address |
9600 Dexter Ave Detroit MI 48206-1816 |
| Practice Telephone | 3138947881 |
| Practice Fax Number | 3138946312 |
| Mailing Telephone | 3138947881 |
| Mailing Fax Number | 3138946312 |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2014-03-28 |
| Authorized Official Name | DR. KARL BANDLIEN (PRESIDENT) |
| Authorized Official Telephone | 3138947881 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
4301046832 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS OF MICHIGAN | 0820397 | 01 |
| MI | 4754287 | 05 |
| Street Address |
9600 DEXTER AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48206-1816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235196023 | Angela Lynn Roman | Nurse Practitioner | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2006-04-27 |
| 1295118842 | Preventative Patterns Care Management | Early Intervention Provider Agency | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2015-07-01 |
| 1770911703 | Romancare Health Services | Nurse Practitioner | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2013-10-30 |
| 1538504626 | Northwest Surgical & Medical Comprehensive Services PC | General Practice | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2013-05-03 |
| 1518238104 | Taylor Comprehensive Care | Family Medicine | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2012-01-13 |
| 1144507682 | Ayhanna Latoya Dennis | Counselor | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2011-11-11 |
| 1730481201 | Dennis Irvine | Counselor | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2010-12-03 |
| 1275833709 | Northwest Industrail Drug Rehabilitation Clinic | Counselor | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2010-11-01 |
| 1679873798 | Northwest Drug Rehabilitation Inc | Clinic/Center | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2010-10-22 |
| 1346540481 | Cathy Ann Haynes | Counselor | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2010-10-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861962094 | Reid Talley | Counselor | 12010 Elmhurst, Detroit, MI 48206 | 2018-11-30 |
| 1306330246 | Harper's Care Club, LLC | Home Health | 1732 W Bethune St Apt 4, Detroit, MI 48206 | 2018-06-14 |
| 1700210440 | Tender Loving Care Assisted Living | Custodial Care Facility | 2250 W.euclid, Detroit, MI 48206 | 2013-08-29 |
| 1063560761 | Platinum Care Pharmacy Inc. | Pharmacy | 8500 14th Street, Detroit, MI 48206 | 2007-01-08 |
| 1619067527 | Young-sims Clinic PC | Family Medicine | 9150 Linwood, Detroit, MI 48206 | 2006-10-13 |
| 1093811200 | Grace W Patterson | Family Medicine | 9150 Linwood Ave, Detroit, MI 48206 | 2006-09-15 |
| 1164437992 | Rosa Park Medical Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8665 Rosa Parks Boulavard, Detroit, MI 48206 | 2006-07-30 |
| 1336495696 | Ephraim I Onwuegbuchu | Pharmacist | 8500 14th Street, Detroit, MI 48206 | 2012-07-24 |
| 1962647552 | Jabez Recovery Management Services, Inc | Substance Abuse Rehabilitation Facility | 2755 Collingwood St, Detroit, MI 48206 | 2008-12-10 |
| 1033215918 | Robert Nmn Sims | Family Medicine | 9150 Linwood Ave, Detroit, MI 48206 | 2006-09-16 |
| Find all providers in zip 48206 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437639051 | Tlc Home and Respite Care LLC | Clinic/Center | 16910 Gardenview Cir, Detroit, MI 48228-4331 | 2018-08-14 |
| 1780997841 | Total Medical Care | Clinic/Center | 3611 Carpenter St Ste 7, Detroit, MI 48212-2784 | 2010-07-19 |
| 1821325176 | Matrix Human Services | Clinic/Center | 450 Eliot, Detroit, MI 48201-2130 | 2009-11-06 |
| 1184892911 | B S Pannu Md PC | Clinic/Center | 7349 E Jefferson Ave, Detroit, MI 48214-2308 | 2008-02-14 |
| 1710188842 | St George Medical Center Inc. | Clinic/Center | 4818 W Vernor Hwy, Detroit, MI 48209-2122 | 2007-05-29 |
| 1174906184 | Detroit Community Health Connection, Inc | Clinic/Center | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2015-07-08 |
| 1699926113 | Bca of Detroit, LLC | Clinic/Center | 15000 Gratiot Ave, Detroit, MI 48205-1973 | 2008-10-02 |
| 1982881025 | Great Lakes Family Medical Center Pllc | Clinic/Center | 4420 E Davison St, Detroit, MI 48212-1744 | 2008-01-30 |
| 1881809226 | Henry Ford Health System | Clinic/Center | 3031 W Grand Blvd, Detroit, MI 48202-3046 | 2007-05-11 |
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|---|---|---|---|---|
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| 1619584570 | Crossover Health Medical Group | Clinic/Center | 19901 Dix Toledo Hwy, Brownstown Twp, MI 48183-1039 | 2020-09-24 |
| 1669087854 | Advance Counseling Services, LLC | Clinic/Center | 110 Trealout Dr Ste 103, Fenton, MI 48430-3211 | 2020-09-14 |
| 1104439033 | Otevwa Homes Inc | Clinic/Center | 6556 Rustic Ridge Trl, Grand Blanc, MI 48439-4956 | 2020-08-29 |
| 1245849827 | Transitions Case Management Education Inc. | Clinic/Center | 26375 Halsted Rd Apt 122, Farmington Hills, MI 48331-3762 | 2020-07-29 |
| 1689204703 | Professional Ergonomics LLC | Clinic/Center | 1754 Central Park Dr Apt H, Okemos, MI 48864-1258 | 2020-01-16 |
| 1598319147 | Crescent Procedure Center Plc | Clinic/Center | 30671 Stephenson Hwy Ste A, Madison Heights, MI 48071-1635 | 2019-07-31 |
| 1164984944 | Rsf Medics Pllc | Clinic/Center | 28511 Ford Rd, Garden City, MI 48135 | 2019-04-02 |
| 1114484540 | Maan Ekkah, Md, PC | Clinic/Center | 4848 Adams Pointe Ct, Troy, MI 48098-4111 | 2019-02-21 |
| 1851877211 | Saleh Medical Innovations Consulting Plc | Clinic/Center | 9308 Hickory Ridge Road, Northville, MI 48167 | 2018-07-18 |
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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.