Organization
LUMINESCENCE CENTER OF MICHIGAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOURA ABDULKADER (AUTHORIZED OFFICIAL)
(734) 476-4849
Entity
Organization
Contact information
Practice address
16085 DIX TOLEDO RD, SOUTHGATE, MI 48195-2950
(734) 476-4849
Mailing address
16085 DIX TOLEDO RD, SOUTHGATE, MI 48195-2950
(734) 476-4849
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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