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Organization
LEO CLINIC INC
Active
Organization
LEO CLINIC INC
Active
Other names
leo clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS MARRERO (CEO)
(860) 249-0975
Entity
Organization
Contact information
Practice address
602 NEW BRITAIN AVE, HARTFORD, CT 06106-4033
(860) 249-0975
Mailing address
602 NEW BRITAIN AVE, HARTFORD, CT 06106-4033
(860) 249-0975
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
—
NULL
261QC1500X
Community Health Clinic/Center
—
NULL
261QD0000X
Dental Clinic/Center
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
261QP2300X
Primary Care Clinic/Center
—
NULL
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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