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General NPI Number Information
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NPI Number | 1720906548
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Entity Type | Organization
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Legal Business Name | LUMINATE WELLNESS AND RECOVERY LLC
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Dates
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Enumeration Date | 07/08/2026
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Last Update Date | 07/08/2026
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Provider Practice Location Address
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Address Line | 17901 MEDLEY DR
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City | ENCINO
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State | CA
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Zip | 91316-4342
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Country | US
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Telephone | 310-740-6162
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Fax |
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Provider Business Mailing Address
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Address Line | 17901 MEDLEY DR
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City | ENCINO
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State | CA
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Zip | 91316-4342
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Country | US
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Telephone | 310-740-6162
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | YVETTE NOWRY
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Credential | RN, BSN
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Telephone | 818-437-4168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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