Organization
ILLUMINATE COMMUNITY RECOVERY SERVICES
Active
Other names
Illuminate Peer Coaching, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER LISTER (FOUNDER - CEO)
(720) 743-3232
Entity
Organization
Contact information
Practice address
2075 SUMMIT ST, FRANKTOWN, CO 80116-8518
(720) 743-3232
Mailing address
2075 SUMMIT ST, FRANKTOWN, CO 80116-8518
(303) 385-1647
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558680116
—
CO
Enumeration date
04/11/2023
Last updated
04/26/2023
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