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Organization

ILLUMINATIONS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBORAH CARNINE L.I.S.W. (OWNER)
(515) 232-7157
Entity
Organization

Contact information

Practice address
515 GRAND AVE STE 104, AMES, IA 50010-6061
(515) 232-7157
(515) 232-7116
Mailing address
515 GRAND AVE STE 104, AMES, IA 50010-6061
(515) 232-7157
(515) 232-7116

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
01108
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0198184
IA
01
1780669556
INDIVIDUAL NPI
Enumeration date
11/07/2012
Last updated
10/28/2020
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