| Illuminate Life Wellness Llc | |
|
126 Pawtuxet Ter West Warwick RI 02893-5212 | |
| (401) 542-9080 | |
| Not Available |
| Full Name | Illuminate Life Wellness Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 126 Pawtuxet Ter, West Warwick, Rhode Island |
| Authorized Official Name and Position | Katherine Kinsella (MANAGER) |
| Authorized Official Contact | 4015429080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminate Life Wellness Llc 126 Pawtuxet Ter West Warwick RI 02893-5212 Ph: () - | Illuminate Life Wellness Llc 126 Pawtuxet Ter West Warwick RI 02893-5212 Ph: (401) 542-9080 |
| NPI Number | 1114512829 |
|---|---|
| Provider Enumeration Date | 03/04/2021 |
| Last Update Date | 03/04/2021 |
| Certification Date | 03/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114512829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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