| NPI | 1396347514 |
|---|---|
| Doing Business As | ILLUMMA |
| Entity Type | Organization |
| Authorized Contact | HOWARD KENNETH ADOLPH Founder/Medical Director 512-750-1348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2020-11-12 |