| NPI | 1649833062 |
|---|---|
| Doing Business As | ILLUMINATE WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | SHELIA BEASLEY Co Owner/ President 423-765-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| 261QI0500X Clinic/Center Infusion Therapy | |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2021-03-03 |