Provider Demographics
NPI:1548405194
Name:LA ALIANZA HISPANA
Entity Type:Organization
Organization Name:LA ALIANZA HISPANA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORK INTERN
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-427-7175
Mailing Address - Street 1:78 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02119-3345
Mailing Address - Country:US
Mailing Address - Phone:617-427-7175
Mailing Address - Fax:617-427-5209
Practice Address - Street 1:78 FOREST ST
Practice Address - Street 2:
Practice Address - City:ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02119-3345
Practice Address - Country:US
Practice Address - Phone:617-427-7175
Practice Address - Fax:617-427-5209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health