Provider Demographics
NPI:1982024790
Name:LUMINOUS CARES, LLC
Entity Type:Organization
Organization Name:LUMINOUS CARES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND PSYCH APN
Authorized Official - Prefix:DR
Authorized Official - First Name:UDOKA
Authorized Official - Middle Name:JEREMIAH
Authorized Official - Last Name:EJIOFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-233-2133
Mailing Address - Street 1:134 EVERGREEN PL
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-2011
Mailing Address - Country:US
Mailing Address - Phone:862-233-2133
Mailing Address - Fax:
Practice Address - Street 1:134 EVERGREEN PL
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-2011
Practice Address - Country:US
Practice Address - Phone:862-233-2133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00374300261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health