Provider Demographics
NPI:1619732310
Name:LATINO CONNECTION FOUNDATION
Entity Type:Organization
Organization Name:LATINO CONNECTION FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PROVIDER NETWORKING
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:BECHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-800-0629
Mailing Address - Street 1:940 E PARK DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-2800
Mailing Address - Country:US
Mailing Address - Phone:717-963-7218
Mailing Address - Fax:
Practice Address - Street 1:940 E PARK DR
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2800
Practice Address - Country:US
Practice Address - Phone:717-963-7218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier