| Leila Community Care | |
|
2940 Hebron Park Dr Ste 101 Hebron KY 41048-9535 | |
| (859) 534-0914 | |
| (859) 534-0914 |
| Full Name | Leila Community Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 2940 Hebron Park Dr Ste 101, Hebron, Kentucky |
| Authorized Official Name and Position | Farduwsa Hassan (NURSE PRACTITIONER) |
| Authorized Official Contact | 4049430150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leila Community Care 2940 Hebron Park Dr Ste 101 Hebron KY 41048-9535 Ph: (404) 934-0150 | Leila Community Care 2940 Hebron Park Dr Ste 101 Hebron KY 41048-9535 Ph: (859) 534-0914 |
| NPI Number | 1144979550 |
|---|---|
| Provider Enumeration Date | 03/22/2022 |
| Last Update Date | 10/11/2024 |
| Medicare PECOS PAC ID | 1658742309 |
|---|---|
| Medicare Enrollment ID | O20230117002808 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144979550 | NPI | - | NPPES |
| H12-235-682 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Farduwsa Hassan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417623471 PECOS PAC ID: 0547667628 Enrollment ID: I20210916003331 |
| Provider Name | Xiaomin Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568236198 PECOS PAC ID: 3173966769 Enrollment ID: I20240212000523 |
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