SALVATION ARMY HARBOR LIGHT MACOMB (NPI# 1508010679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508010679 |
| Entity Type | Organization |
| Organization Name | SALVATION ARMY HARBOR LIGHT MACOMB |
| Practice Address |
14030 Lakeside Blvd N Apt C-221 Shelby Township MI 48315-6050 |
| Mailing Address |
42590 Stepnitz Dr Clinton Township MI 48036-3161 |
| Practice Telephone | 5862127734 |
| Enumeration Date | 2008-11-15 |
| Last Update Date | 2008-11-15 |
| Authorized Official Name | MAJOR SEAVER (SITE SUPERVISOR) |
| Authorized Official Telephone | 5869541838 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Street Address |
14030 LAKESIDE BLVD N APT C-221 |
| City | SHELBY TOWNSHIP |
| State | MI |
| Zip Code | 48315-6050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922457605 | Vernice Moore | Technician, Other | 14030 Lakeside Blvd N, Bldg C Apt 230, Shelby Township, MI 48315-6050 | 2016-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885500 | Steven William Scavone | Counselor | 45660 Schonherr Rd., Shelby Township, MI 48315 | 2020-09-08 |
| 1861039844 | Lauren Nicole Himmel | Physician Assistant | 13051 Michael Dr., Shelby Twp., MI 48315 | 2019-12-09 |
| 1881173763 | Shelby Family Cosmetic & Restorative Dentistry | Dentist | 51221 Schoenherr Road., Suite 102, Shelby Township, MI 48315 | 2018-08-10 |
| 1023594223 | Apex Chiropractic, P.C. | Chiropractor | 51543 Schoenherr Road, Shelby Township, MI 48315 | 2018-07-11 |
| 1053809145 | Bam Management | Clinic/Center | 13433 Hall Road, Utica, MI 48315 | 2018-04-25 |
| 1659723203 | Patricia Gates | Registered Nurse | 23066 Balcombe, Utica, MI 48315 | 2016-07-07 |
| 1124481213 | Jai Shree Umiya Inc | Durable Medical Equipment & Medical Supplies | 13350 24 Mile Rd Ste 300, Shelby Township, MI 48315 | 2016-04-05 |
| 1679931828 | Team Rehabilitation S3, LLC | Physical Therapist | 13350 24 Mile Road, Suite 500, Shelby Township, MI 48315 | 2016-02-03 |
| 1164816484 | Sylvia White | Case Manager/Care Coordinator | 47100 Schoenherr Rd. Suite D, Shelby Township, MI 48315 | 2015-03-25 |
| 1770921389 | Amy Christine Vitale | Speech-Language Pathologist | 14145 Simone Dr., Developing Connections Inc, Shelby Twp, MI 48315 | 2013-06-06 |
| Find all providers in zip 48315 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083237051 | Twin Doves I LLC | Community Based Residential Treatment Facility, Mental Illness | 48617 36th Ave., Bangor, MI 49013 | 2020-05-25 |
| 1104452812 | New Vision of Integrative Services, Inc | Community Based Residential Treatment Facility, Mental Illness | 3505 Walnut St Ste C, Inkster, MI 48141-2952 | 2020-03-14 |
| 1124665054 | Baseline, L.L.C. | Community Based Residential Treatment Facility, Mental Illness | 122 W Crosstown Pkwy, Kalamazoo, MI 49001-2742 | 2019-12-10 |
| 1407491277 | Twin Doves II LLC | Community Based Residential Treatment Facility, Mental Illness | 40739 80th Ave, Decatur, MI 49045-8158 | 2019-11-15 |
| 1710528617 | Larry J Graham Jr. | Community Based Residential Treatment Facility, Mental Illness | 1284 Maurer Ave, Pontiac, MI 48342-1960 | 2019-10-01 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1669937603 | Community Living Options | Community Based Residential Treatment Facility, Mental Illness | 1206 Bronson Cir, Kalamazoo, MI 49008-2325 | 2019-02-04 |
| 1235607854 | Csm Serenity Homes, LLC | Community Based Residential Treatment Facility, Mental Illness | 1714 W 32nd St, Holland, MI 49423-7311 | 2018-11-13 |
| 1750859229 | The Noble Home II, Inc | Community Based Residential Treatment Facility, Mental Illness | 327 E Grand Blvd, Detroit, MI 48207-3616 | 2018-11-02 |
| 1679048870 | Neighborhood Living Services,inc. | Community Based Residential Treatment Facility, Mental Illness | 23001 Norfolk St, Detroit, MI 48219-1185 | 2018-10-04 |
| Find all providers with the same taxonomy | ||||
| City | SHELBY TOWNSHIP |
| Zip Code | 48315 |
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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.