| Our Village Llc | |
|
26 Loller Rd Hamden CT 06514-4316 | |
| (203) 214-3891 | |
| Not Available |
| Full Name | Our Village Llc |
|---|---|
| Speciality | Social Worker |
| Location | 26 Loller Rd, Hamden, Connecticut |
| Authorized Official Name and Position | Guinell Stanley (OWNER) |
| Authorized Official Contact | 2032143891 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Our Village Llc 26 Loller Rd Hamden CT 06514-4316 Ph: (203) 214-3891 | Our Village Llc 26 Loller Rd Hamden CT 06514-4316 Ph: (203) 214-3891 |
| NPI Number | 1144938838 |
|---|---|
| Provider Enumeration Date | 11/10/2022 |
| Last Update Date | 11/10/2022 |
| Certification Date | 11/10/2022 |
| Medicare PECOS PAC ID | 3779954458 |
|---|---|
| Medicare Enrollment ID | O20230116000823 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144938838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Guinell L Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962931030 PECOS PAC ID: 6002181773 Enrollment ID: I20230116000842 |
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