Provider Demographics
NPI:1033508114
Name:LUMINIS HEALTH PATHWAYS, INC.
Entity Type:Organization
Organization Name:LUMINIS HEALTH PATHWAYS, INC.
Other - Org Name:ANNE ARUNDEL GENERAL TREATMENT SERVICES, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-573-5454
Mailing Address - Street 1:PO BOX 64725
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4725
Mailing Address - Country:US
Mailing Address - Phone:410-573-5454
Mailing Address - Fax:
Practice Address - Street 1:2620 RIVA RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7305
Practice Address - Country:US
Practice Address - Phone:410-573-5454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD903106324500000X, 3245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD218240OtherMAMSI
MD58127901OtherCAREFIRST OF MARYLAND
MDHB6OtherCAREFIRST OF DC