Organization
ILLIUMINATED HOME HEALTH CARE LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM B. DAVIS (PRESIDENT)
(952) 261-9935
Entity
Organization
Contact information
Practice address
175 CHARLES AVE, 328, SAINT PAUL, MN 55103-2054
(952) 261-9935
(651) 224-2857
Mailing address
175 CHARLES AVENUE, 328, ST. PAUL, MN 55103
(952) 261-9935
(651) 224-2857
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
904066000
MN
Other
Enumeration date
01/05/2007
Last updated
06/24/2008
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