| NPI | 1922703370 |
|---|---|
| Doing Business As | ILLUMINATION RECOVERY |
| Entity Type | Organization |
| Authorized Contact | THEO HANSON Co Owner 541-231-0850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| 261Q00000X | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-12-15 |