| Illuma Behavioral Health Llc | |
|
267 County Road 558 Tillatoba MS 38961-3101 | |
| (719) 286-0774 | |
| Not Available |
| Full Name | Illuma Behavioral Health Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 267 County Road 558, Tillatoba, Mississippi |
| Authorized Official Name and Position | Nicole Parks (COFOUNDER) |
| Authorized Official Contact | 7046147228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuma Behavioral Health Llc 3609 Austin Bluffs Pkwy Ste 31 Colorado Springs CO 80918-6658 Ph: () - | Illuma Behavioral Health Llc 267 County Road 558 Tillatoba MS 38961-3101 Ph: (719) 286-0774 |
| NPI Number | 1578424446 |
|---|---|
| Provider Enumeration Date | 11/20/2025 |
| Last Update Date | 11/20/2025 |
| Certification Date | 11/20/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578424446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |