LAUREL LIGHT LLC. NPI 1609577311

NPI Information

  • NPI: 1609577311
  • Provider Name: LAUREL LIGHT LLC.
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • CLIA Number: 31D2271933
  • Address: 801 BIRCHFIELD DR
    MOUNT LAUREL, NJ
    ZIP 08054
  • Phone: (703) 955-0587

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NPI Details

LAUREL LIGHT LLC. is a rehabilitation and substance use disorder clinic center in Mount Laurel, NJ. LAUREL LIGHT LLC. NPI is 1609577311. The provider is registered as an organization entity type.

The provider's business location address is:

801 BIRCHFIELD DR
MOUNT LAUREL, NJ
ZIP 08054-015
Phone: (703) 955-0587

The provider's authorized official is Michael Rodgers .
The authorized official title is Cmo and has the following contact phone number (267) 687-9008.

The CLIA number assigned to this NPI record is 31D2271933 - other - outpt sud treatment facil with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/10/2023 and was last updated on 3/10/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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