Provider Demographics
NPI:1841057171
Name:LUMINOUS LIFE CARE SERVICES INC
Entity type:Organization
Organization Name:LUMINOUS LIFE CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHIMEZIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:ONYIMA
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:240-491-7953
Mailing Address - Street 1:13607 WOOD EMBER DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4201
Mailing Address - Country:US
Mailing Address - Phone:240-491-7953
Mailing Address - Fax:
Practice Address - Street 1:702 OGLETHORPE ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2735
Practice Address - Country:US
Practice Address - Phone:202-713-7890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities