| Luminous Cares, Llc | |
|
134 Evergreen Pl East Orange NJ 07018-2011 | |
| (862) 233-2133 | |
| Not Available |
| Full Name | Luminous Cares, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 134 Evergreen Pl, East Orange, New Jersey |
| Authorized Official Name and Position | Udoka Jeremiah Ejiofor (PRESIDENT AND PSYCH APN) |
| Authorized Official Contact | 8622332133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminous Cares, Llc 134 Evergreen Pl East Orange NJ 07018-2011 Ph: (862) 233-2133 | Luminous Cares, Llc 134 Evergreen Pl East Orange NJ 07018-2011 Ph: (862) 233-2133 |
| NPI Number | 1982024790 |
|---|---|
| Provider Enumeration Date | 04/18/2014 |
| Last Update Date | 04/18/2014 |
| Medicare PECOS PAC ID | 2264651801 |
|---|---|
| Medicare Enrollment ID | O20140915001191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982024790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 26NJ00374300 (New Jersey) | Primary |
| Provider Name | Udoka J Ejiofor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295096584 PECOS PAC ID: 6305094871 Enrollment ID: I20120907000575 |
| Provider Name | Stacy D Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720316565 PECOS PAC ID: 1557687225 Enrollment ID: I20150225000296 |
| Provider Name | Donna E Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114110699 PECOS PAC ID: 5395063010 Enrollment ID: I20150409000622 |
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