Organization
NEW LIGHT RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN ARNOLD MS/P, CADC, SST (PROGRAM MANAGER)
(313) 867-8015
Entity
Organization
Contact information
Practice address
300 W MCNICHOLS RD, DETROIT, MI 48203-2703
(313) 867-8015
(313) 867-8040
Mailing address
300 W MCNICHOLS RD, DETROIT, MI 48203-2703
(313) 867-8015
(313) 867-8040
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
821624
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437236940
—
MI
Enumeration date
12/10/2013
Last updated
12/10/2013
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