| Joyful Alegria Llc | |
|
2545 Blake Rd Portage IN 46368-1817 | |
| (219) 413-1817 | |
| Not Available |
| Full Name | Joyful Alegria Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2545 Blake Rd, Portage, Indiana |
| Authorized Official Name and Position | Yolanda Casillas (FOUNDER) |
| Authorized Official Contact | 2194874388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joyful Alegria Llc 2545 Blake Rd Portage IN 46368-1817 Ph: (219) 413-1817 | Joyful Alegria Llc 2545 Blake Rd Portage IN 46368-1817 Ph: (219) 413-1817 |
| NPI Number | 1104514512 |
|---|---|
| Provider Enumeration Date | 04/25/2023 |
| Last Update Date | 04/29/2023 |
| Certification Date | 04/29/2023 |
| Medicare PECOS PAC ID | 9739527664 |
|---|---|
| Medicare Enrollment ID | O20240410002980 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104514512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Yolanda A Casillas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831702489 PECOS PAC ID: 1557709482 Enrollment ID: I20240410003028 |
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