Healthcare Provider Details
I. General information
NPI: 1821939216
Provider Name (Legal Business Name): LUMI DEVELOPMENTAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4160 E WOODSIDE CT
GILBERT AZ
85297-3572
US
IV. Provider business mailing address
4160 E WOODSIDE CT
GILBERT AZ
85297-3572
US
V. Phone/Fax
- Phone: 619-733-0682
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 224ZF0002X |
| Taxonomy | Feeding, Eating & Swallowing Occupational Therapy Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JENNIFER
BRASWELL
Title or Position: MANAGING MEMBER
Credential:
Phone: 619-733-0682