Provider Demographics
NPI:1255571790
Name:GUADALUPE INTERVENTION, INC.
Entity type:Organization
Organization Name:GUADALUPE INTERVENTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:EDIE
Authorized Official - Last Name:GUADALUPE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:914-489-5574
Mailing Address - Street 1:14 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-3506
Mailing Address - Country:US
Mailing Address - Phone:914-489-5574
Mailing Address - Fax:914-235-0222
Practice Address - Street 1:14 NORTH AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-3506
Practice Address - Country:US
Practice Address - Phone:914-489-5574
Practice Address - Fax:914-235-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty