Provider Demographics
NPI:1619360880
Name:CENTRO SOCIAL LA ESPERANZA, INC.
Entity Type:Organization
Organization Name:CENTRO SOCIAL LA ESPERANZA, INC.
Other - Org Name:ESPERANZA CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-928-5810
Mailing Address - Street 1:516 W 181ST ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-5150
Mailing Address - Country:US
Mailing Address - Phone:212-928-5810
Mailing Address - Fax:212-740-2053
Practice Address - Street 1:516 W 181ST ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-5150
Practice Address - Country:US
Practice Address - Phone:212-928-5810
Practice Address - Fax:212-740-2053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6245833251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01997108Medicaid
NY02245903Medicaid
NY02704772Medicaid
NY02592547Medicaid