| Illuminare | |
|
601 Greene Dr Greenville KY 42345-1451 | |
| (270) 377-7137 | |
| (270) 641-0857 |
| Full Name | Illuminare |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 601 Greene Dr, Greenville, Kentucky |
| Authorized Official Name and Position | Gretchen Davis (CEO) |
| Authorized Official Contact | 2703777137 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminare Po Box 42 Powderly KY 42367-0042 Ph: (270) 377-7137 | Illuminare 601 Greene Dr Greenville KY 42345-1451 Ph: (270) 377-7137 |
| NPI Number | 1992288518 |
|---|---|
| Provider Enumeration Date | 09/10/2018 |
| Last Update Date | 09/09/2022 |
| Certification Date | 09/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992288518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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