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Organization
THE LATIN ENRICHMENT ORGANIZATION
Active
Organization
THE LATIN ENRICHMENT ORGANIZATION
Active
Other names
LEO Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS MARRERO MSW, ACSW (CLINIC DIRECTOR)
(860) 249-0975
Entity
Organization
Contact information
Practice address
54 FOREST ST, HARTFORD, CT 06105-3204
(860) 249-0975
(860) 249-0975
Mailing address
PO BOX 380322, HARTFORD, CT 06138-0322
(860) 249-0975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
NULL
207QA0000X
Adolescent Medicine (Family Medicine) Physician
—
—
207QA0505X
Adult Medicine Physician
—
NULL
207QA0505X
Adult Medicine Physician
—
—
261QD0000X
Dental Clinic/Center
—
NULL
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
12/16/2020
Last updated
02/24/2021
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