Provider Demographics
NPI:1063243749
Name:LUMINATE HOME CARE, LLC
Entity type:Organization
Organization Name:LUMINATE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:NEEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-841-9037
Mailing Address - Street 1:930 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE ODESSA
Mailing Address - State:MI
Mailing Address - Zip Code:48849-1003
Mailing Address - Country:US
Mailing Address - Phone:616-755-0938
Mailing Address - Fax:888-507-5736
Practice Address - Street 1:930 4TH AVE
Practice Address - Street 2:
Practice Address - City:LAKE ODESSA
Practice Address - State:MI
Practice Address - Zip Code:48849-1003
Practice Address - Country:US
Practice Address - Phone:616-755-0938
Practice Address - Fax:888-507-5736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care