| Illuminations, Inc. | |
|
515 Grand Ave Ste 104 Ames IA 50010-6061 | |
| (515) 232-7157 | |
| (515) 232-7116 |
| Full Name | Illuminations, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 515 Grand Ave Ste 104, Ames, Iowa |
| Authorized Official Name and Position | Deborah Carnine (OWNER) |
| Authorized Official Contact | 5152327157 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminations, Inc. 515 Grand Ave Ste 104 Ames IA 50010-6061 Ph: (515) 232-7157 | Illuminations, Inc. 515 Grand Ave Ste 104 Ames IA 50010-6061 Ph: (515) 232-7157 |
| NPI Number | 1871847202 |
|---|---|
| Provider Enumeration Date | 11/07/2012 |
| Last Update Date | 10/28/2020 |
| Certification Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871847202 | NPI | - | NPPES |
| 0198184 | Medicaid | IA | |
| 1780669556 | Other | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 01108 (Iowa) | Primary |
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