Specialty Social Services At Home, Llc | |
145 Adelaide St Fairfield CT 06825-7402 | |
(203) 380-0320 | |
(203) 380-0320 |
Full Name | Specialty Social Services At Home, Llc |
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Speciality | Social Worker |
Location | 145 Adelaide St, Fairfield, Connecticut |
Authorized Official Name and Position | Yoberki Reyes (MEMBER) |
Authorized Official Contact | 2033380320 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Specialty Social Services At Home, Llc 145 Adelaide St Fairfield CT 06825-7402 Ph: (203) 380-0320 | Specialty Social Services At Home, Llc 145 Adelaide St Fairfield CT 06825-7402 Ph: (203) 380-0320 |
NPI Number | 1760843692 |
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Provider Enumeration Date | 03/20/2016 |
Last Update Date | 08/03/2016 |
Medicare PECOS PAC ID | 8325330590 |
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Medicare Enrollment ID | O20160708000009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760843692 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 006253 (Connecticut) | Primary |
Provider Name | Yoberki Reyes |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1629454780 PECOS PAC ID: 1052603222 Enrollment ID: I20160708000017 |
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