Provider Demographics
NPI:1366508004
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 1:2000 MEDICAL PKWY STE 606
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3748
Mailing Address - Country:US
Mailing Address - Phone:443-481-1308
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:2006-12-28
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD903106261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD58127901OtherCAREFIRST OF MD
DCHB6OtherCAREFIRST OF DC
MD757055400Medicaid
MD218240OtherMAMSI