| Aldea Healing Center Pllc | |
|
11075 S State St Ste 3101 Sandy UT 84070-5164 | |
| (321) 754-4884 | |
| Not Available |
| Full Name | Aldea Healing Center Pllc |
|---|---|
| Speciality | Counselor |
| Location | 11075 S State St Ste 3101, Sandy, Utah |
| Authorized Official Name and Position | Gina Toledo (THERAPIST) |
| Authorized Official Contact | 8015564826 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aldea Healing Center Pllc 12562 S Kimber Ln Riverton UT 84065-4310 Ph: (801) 556-4826 | Aldea Healing Center Pllc 11075 S State St Ste 3101 Sandy UT 84070-5164 Ph: (321) 754-4884 |
| NPI Number | 1093409146 |
|---|---|
| Provider Enumeration Date | 06/02/2023 |
| Last Update Date | 05/15/2024 |
| Certification Date | 05/15/2024 |
| Medicare PECOS PAC ID | 8527503127 |
|---|---|
| Medicare Enrollment ID | O20240708002320 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093409146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Gina Toledo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295206852 PECOS PAC ID: 3072058676 Enrollment ID: I20240715004149 |
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