Provider Demographics
NPI:1750586442
Name:ESPERANZA GUIDANCE SERVICE INC
Entity type:Organization
Organization Name:ESPERANZA GUIDANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:VILLALOBOS
Authorized Official - Last Name:MADEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:575-522-5144
Mailing Address - Street 1:1401 S DON ROSER DR STE A2
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4567
Mailing Address - Country:US
Mailing Address - Phone:575-522-5144
Mailing Address - Fax:575-522-5177
Practice Address - Street 1:1401 S DON ROSER DR STE A2
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4567
Practice Address - Country:US
Practice Address - Phone:575-522-5144
Practice Address - Fax:575-522-5177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0100941101YM0800X
NMM-063721041C0700X
NMI-31331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty