Illuminate Life Wellness LLC
NPI #1114512829 in West Warwick, Rhode Island
Provider Information
- NPI Number
- 1114512829
- Entity Type
- Organization
- Organization Name
- Illuminate Life Wellness LLC
- Primary Specialty
- Clinic/Center - Adult Mental Health
- Enumeration Date
- Mar 4, 2021
- Last Updated
- Mar 4, 2021
Practice Location
- Address
- 126 PAWTUXET TER
- City
- West Warwick
- State
- Rhode Island
- ZIP Code
- 02893-5212
- Phone
- (401) 542-9080
Authorized Official
- Name
- KATHERINE KINSELLA
- Title
- MANAGER
- Phone
- (401) 542-9080
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adult Mental Health — Adult Mental Health |
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