| NPI | 1285453811 |
|---|---|
| Doing Business As | LEO CLINIC |
| Entity Type | Organization |
| Authorized Contact | CARLOS MARRERO CEO 860-249-0975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent |
| 261QC1500X Clinic/Center, Community Health | |
| 261QD0000X Clinic/Center, Dental | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-10-09 |
| Last Update Date | 2024-10-09 |