Provider Demographics
NPI:1013540764
Name:LUMINOUS CARE SERVICES
Entity Type:Organization
Organization Name:LUMINOUS CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADETUTU
Authorized Official - Middle Name:OLAITAN
Authorized Official - Last Name:AKINBAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-577-0044
Mailing Address - Street 1:5618 OAKFORD RD
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-4205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5618 OAKFORD RD
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-4205
Practice Address - Country:US
Practice Address - Phone:240-577-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility