MEDICARE: LUMIERE CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1598617359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMIERE CARE LLC

Provider Business Mailing Address
First Line	:	2192 PORT TALBOT PL
Second Line	:
City	:	CORALVILLE
State	:	IA
Zip	:	52241-3441
Country	:	US
Telephone Number	:	319-471-6694
Fax Number	:

Provider Business Practice Location Address
First Line	:	2192 PORT TALBOT PL
Second Line	:
City	:	CORALVILLE
State	:	IA
Zip	:	52241-3441
Country	:	US
Telephone Number	:	319-471-6694
Fax Number	:

Authorized Official
Title or Position	:	MANGER
Name	:	ANNA EGBE
Credential	:
Telephone Number	:	708-265-7073

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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Directions to “LUMIERE CARE LLC ” Practice Location

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