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General NPI Number Information
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NPI Number | 1427698125
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Entity Type | Organization
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Legal Business Name | LUMINIS HEALTH MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 01/10/2020
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 175 HARRY S TRUMAN PKWY
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City | ANNAPOLIS
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State | MD
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Zip | 21401-7573
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Country | US
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Telephone | 443-481-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 MEDICAL PKWY STE 409
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3746
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AO
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Name | MELISSA RAPATTONI
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Credential |
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Telephone | 443-481-5136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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