Organization
ILLUMINATION GERIATRIC CONSULTATION AND COUNSELING SERVICES
Active
Organization
ILLUMINATION GERIATRIC CONSULTATION AND COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN MARY MILLER LCSW (LICENSED CLINICAL SOCIAL WORKER/CEO)
(818) 568-6244
Entity
Organization
Contact information
Practice address
1832 SCOTT RD, BURBANK, CA 91504-3819
(818) 568-6244
Mailing address
1832 SCOTT RD, BURBANK, CA 91504-3819
(818) 568-6244
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
26431
CA
Other
Enumeration date
10/04/2010
Last updated
10/04/2010
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