| L&l Life Enrichment Center Llc | |
|
125 Liberty St Springfield MA 01103-1114 | |
| (347) 458-0085 | |
| Not Available |
| Full Name | L&l Life Enrichment Center Llc |
|---|---|
| Speciality | Psychologist |
| Location | 125 Liberty St, Springfield, Massachusetts |
| Authorized Official Name and Position | Lolita Hanley (OWNER) |
| Authorized Official Contact | 3474580085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| L&l Life Enrichment Center Llc 125 Liberty St Springfield MA 01103-1114 Ph: (347) 458-0085 | L&l Life Enrichment Center Llc 125 Liberty St Springfield MA 01103-1114 Ph: (347) 458-0085 |
| NPI Number | 1346892437 |
|---|---|
| Provider Enumeration Date | 07/10/2019 |
| Last Update Date | 07/16/2019 |
| Medicare PECOS PAC ID | 6406282987 |
|---|---|
| Medicare Enrollment ID | O20200131000200 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346892437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lolita M. Hanley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619270196 PECOS PAC ID: 7214363795 Enrollment ID: I20200131000369 |
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