Healthcare Provider Details

I. General information

NPI: 1598695728
Provider Name (Legal Business Name): ILLUMINATE AUTISM SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 FEDERAL RD
BROOKFIELD CT
06804-2418
US

IV. Provider business mailing address

PO BOX 542
WESTPORT CT
06881-0542
US

V. Phone/Fax

Practice location:
  • Phone: 646-620-7017
  • Fax:
Mailing address:
  • Phone: 646-620-7017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DHRUV PIPLANI
Title or Position: MANAGING PARTNER
Credential:
Phone: 646-620-7017