Provider Demographics
NPI:1396188397
Name:VILLA ESPERANZA SERVICES
Entity type:Organization
Organization Name:VILLA ESPERANZA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAMION
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-449-2919
Mailing Address - Street 1:2060 E VILLA ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-2340
Mailing Address - Country:US
Mailing Address - Phone:626-449-2919
Mailing Address - Fax:626-449-2850
Practice Address - Street 1:1115 N CHESTER AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-2946
Practice Address - Country:US
Practice Address - Phone:626-791-1823
Practice Address - Fax:626-449-2850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities