Organization
ILLUMINATED DIRECTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LACEWELL (CEO)
(919) 452-7931
Entity
Organization
Contact information
Practice address
312 N CHARLES ST, STE 300 & 400, BALTIMORE, MD 21201-4322
(703) 542-4181
Mailing address
2628 CAMELLIA DR, APT C, DURHAM, NC 27705-2054
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/10/2016
Last updated
04/17/2023
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