Organization
THE ILLUMINATION FOUNDATION
Active
Other names
Pathways to Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON NICOLE SMITH (EXECUTIVE DIRECTOR)
(870) 315-5137
Entity
Organization
Contact information
Practice address
248 UNION ROAD 295, EL DORADO, AR 71730-8742
(870) 315-5137
Mailing address
248 UNION ROAD 295, EL DORADO, AR 71730-8742
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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