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SALVATION ARMY-HARBOR LIGHT NPI 1811094998


NPI Information

NPI: 1811094998
Provider Name: SALVATION ARMY-HARBOR LIGHT
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
3737 LAWTON ST
DETROIT, MI
ZIP 48208
Phone: (313) 361-6136
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SALVATION ARMY-HARBOR LIGHT is a substance abuse rehabilitation facility in Detroit, MI. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. SALVATION ARMY-HARBOR LIGHT NPI is 1811094998. The provider is registered as an organization entity type.

The provider's business location address is:

3737 LAWTON ST
DETROIT, MI
ZIP 48208-500
Phone: (313) 361-6136
Fax: (313) 361-6210

The provider's authorized official is Cynthia Mainville .
The authorized official title is Cfo and has the following contact phone number (313) 361-6136.

The enumeration date for this NPI number is 9/20/2006 and was last updated on 4/21/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1385H00000XRespite CareNo
2324500000XSubstance Abuse Rehabilitation Facility4301061866MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14701194MEDICAIDMICHIGAN

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: 11/14/2023

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