| Buscando Mi Destino,llc | |
|
56 Arbor St Optional Hartford CT 06106 | |
| (860) 209-0696 | |
| Not Available |
| Full Name | Buscando Mi Destino,llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 56 Arbor St, Hartford, Connecticut |
| Authorized Official Name and Position | Lleidy Ivelisse De Leon (OWNER) |
| Authorized Official Contact | 8602090696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Buscando Mi Destino,llc 1406 Trout Brook Dr West Hartford CT 06117-2653 Ph: (860) 209-0696 | Buscando Mi Destino,llc 56 Arbor St Optional Hartford CT 06106 Ph: (860) 209-0696 |
| NPI Number | 1033874516 |
|---|---|
| Provider Enumeration Date | 11/01/2021 |
| Last Update Date | 11/01/2021 |
| Certification Date | 11/01/2021 |
| Medicare PECOS PAC ID | 5799175345 |
|---|---|
| Medicare Enrollment ID | O20211214001524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033874516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Lleidy Ivelisse De Leon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417324914 PECOS PAC ID: 0042616518 Enrollment ID: I20210908003126 |
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