Healthcare Provider Details

I. General information

NPI: 1629492459
Provider Name (Legal Business Name): HOPE ESPERANZA SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2014
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 N WASHINGTON AVE
DUNELLEN NJ
08812-1243
US

IV. Provider business mailing address

191 NORTH AVE #147
DUNELLEN NJ
08812-1277
US

V. Phone/Fax

Practice location:
  • Phone: 732-474-0295
  • Fax: 732-582-2722
Mailing address:
  • Phone: 732-474-7378
  • Fax: 732-582-2722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number44SC05631900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number44SC05631900
License Number StateNJ

VIII. Authorized Official

Name: MS. DIANA MENDEZ
Title or Position: C.E.O
Credential: LCSW,CSSW
Phone: 732-474-7378