Provider Demographics
NPI:1700918026
Name:ESPERANZA HOME HEALTH CARE HOSPICE, INC.
Entity Type:Organization
Organization Name:ESPERANZA HOME HEALTH CARE HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-387-2215
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:MORA
Mailing Address - State:NM
Mailing Address - Zip Code:87732-0270
Mailing Address - Country:US
Mailing Address - Phone:575-387-2215
Mailing Address - Fax:575-387-9047
Practice Address - Street 1:2183 STATE HWY. 518
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:NM
Practice Address - Zip Code:87712
Practice Address - Country:US
Practice Address - Phone:575-387-2215
Practice Address - Fax:575-387-9047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6361251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00NM00HH18OtherBLUE CROSS BLUE SHIELD
NMB7678Medicaid
NML0166Medicaid
NMN2356Medicaid
NM201079300OtherPRESBYTERIAN HEALTH PLAN
NM321512Medicare ID - Type UnspecifiedHOSPICE
NM201079300OtherPRESBYTERIAN HEALTH PLAN