Provider Demographics
NPI:1124376371
Name:ESPERANZA PARA FAMILIAS LLC
Entity Type:Organization
Organization Name:ESPERANZA PARA FAMILIAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:EUGENIA
Authorized Official - Middle Name:TEODOCIA
Authorized Official - Last Name:APAZA-COAQUIRA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:952-854-1239
Mailing Address - Street 1:1313 E 66TH ST STE B103
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-4577
Mailing Address - Country:US
Mailing Address - Phone:952-854-1239
Mailing Address - Fax:952-843-5663
Practice Address - Street 1:1313 E 66TH ST STE B103
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-4577
Practice Address - Country:US
Practice Address - Phone:952-854-1239
Practice Address - Fax:952-843-5663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-20
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN181301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty