| Lifetent Behavioral Health, Llc | |
|
100 Front St Ste 401 Worcester MA 01608-1425 | |
| (508) 635-0144 | |
| (508) 635-5414 |
| Full Name | Lifetent Behavioral Health, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 100 Front St Ste 401, Worcester, Massachusetts |
| Authorized Official Name and Position | Chukwuemeka Asiegbu (OWNER/PROVIDER) |
| Authorized Official Contact | 5086350144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetent Behavioral Health, Llc 100 Front St Ste 401 Worcester MA 01608-1425 Ph: () - | Lifetent Behavioral Health, Llc 100 Front St Ste 401 Worcester MA 01608-1425 Ph: (508) 635-0144 |
| NPI Number | 1699451302 |
|---|---|
| Provider Enumeration Date | 06/26/2023 |
| Last Update Date | 11/02/2023 |
| Certification Date | 09/19/2023 |
| Medicare PECOS PAC ID | 5698206209 |
|---|---|
| Medicare Enrollment ID | O20241008000154 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699451302 | NPI | - | NPPES |
| Provider Name | Chukwuemeka Asiegbu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023745759 PECOS PAC ID: 1355790759 Enrollment ID: I20231211002484 |
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