NPI | 1720840846 |
---|---|
Doing Business As | ILLUMINATE MENTAL HEALTH |
Entity Type | Organization |
Authorized Contact | MATTHEW MEWHORTER Vice President/Officer 540-222-3495 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2024-01-24 |
Last Update Date | 2024-01-24 |