Organization
ILLUMA BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE PARKS BCBA, IBA, LBA (COFOUNDER)
(704) 614-7228
Entity
Organization
Contact information
Practice address
267 COUNTY ROAD 558, TILLATOBA, MS 38961-3101
(719) 286-0774
Mailing address
3609 AUSTIN BLUFFS PKWY STE 31, COLORADO SPRINGS, CO 80918-6658
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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