| Lenoras Light | |
|
22804 Sharrow Ave Warren MI 48089-2882 | |
| (313) 854-5102 | |
| (313) 251-7344 |
| Full Name | Lenoras Light |
|---|---|
| Speciality | Clinic/Center |
| Location | 22804 Sharrow Ave, Warren, Michigan |
| Authorized Official Name and Position | Zenobia Kindle-davis (THERAPIST/OWNER) |
| Authorized Official Contact | 3138545102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lenoras Light 22804 Sharrow Ave Warren MI 48089-2882 Ph: (313) 854-5102 | Lenoras Light 22804 Sharrow Ave Warren MI 48089-2882 Ph: (313) 854-5102 |
| NPI Number | 1205441722 |
|---|---|
| Provider Enumeration Date | 09/11/2020 |
| Last Update Date | 02/04/2022 |
| Certification Date | 02/04/2022 |
| Medicare PECOS PAC ID | 1153730221 |
|---|---|
| Medicare Enrollment ID | O20210503001488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205441722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Zenobia Kindle-davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285287862 PECOS PAC ID: 2062821135 Enrollment ID: I20210503001602 |
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