Organization
LEON TEC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SOPHIA B CARLSSON (MEDICAL BILLER)
(203) 322-1479
Entity
Organization
Contact information
Practice address
11 ROCKYFIELD RD, WESTPORT, CT 06880-2202
(203) 227-1331
(203) 227-2439
Mailing address
11 ROCKYFIELD RD, WESTPORT, CT 06880-2202
(203) 227-1331
(203) 227-2439
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
09529
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260000153
060862585
CT
Enumeration date
01/14/2009
Last updated
01/14/2009
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