LUMINOUS CARE LLC NPI 1467066639

NPI Information

NPI: 1467066639
Provider Name: LUMINOUS CARE, LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
285 BOULEVARD NE STE 145
ATLANTA, GA
ZIP 30312
Phone: (844) 884-9691
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LUMINOUS CARE, LLC is a health service clinic center in Atlanta, GA. LUMINOUS CARE, LLC NPI is 1467066639. The provider is registered as an organization entity type.

The provider's business location address is:

285 BOULEVARD NE STE 145
ATLANTA, GA
ZIP 30312-204
Phone: (844) 884-9691
Fax: (404) 907-4052

The provider's authorized official is Andrea Jefferson-saboor .
The authorized official title is Fnp and has the following contact phone number (404) 354-6988.

The enumeration date for this NPI number is 9/3/2020 and was last updated on 9/11/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000899643	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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