Provider Demographics
NPI:1457470114
Name:ESPERANZA CASE MANAGEMENT
Entity Type:Organization
Organization Name:ESPERANZA CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-884-0100
Mailing Address - Street 1:3636 MENAUL BLVD NE STE 112
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-2842
Mailing Address - Country:US
Mailing Address - Phone:505-884-0100
Mailing Address - Fax:505-296-4181
Practice Address - Street 1:3636 MENAUL BLVD NE STE 112
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-2842
Practice Address - Country:US
Practice Address - Phone:505-884-0100
Practice Address - Fax:505-296-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMFA0052966251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management