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General NPI Number Information
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NPI Number | 1285253286
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Entity Type | Organization
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Legal Business Name | ILLUMINATION HEALTH AND HOME
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 883 S ANAHEIM BLVD
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City | ANAHEIM
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State | CA
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Zip | 92805-5204
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Country | US
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Telephone | 949-273-0555
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Fax |
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Provider Business Mailing Address
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Address Line | 2871 PULLMAN ST
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City | SANTA ANA
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State | CA
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Zip | 92705-5713
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Country | US
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Telephone | 949-273-0555
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. POOJA BHALLA
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Credential | DNP,RN
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Telephone | 949-502-0339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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