Healthcare Provider Details

I. General information

NPI: 1396073243
Provider Name (Legal Business Name): NUEVA ESPERANZA ACADEMY CHARTER SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 12/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W HUNTING PARK AVE
PHILADELPHIA PA
19140-2625
US

IV. Provider business mailing address

301 W HUNTING PARK AVE
PHILADELPHIA PA
19140-2625
US

V. Phone/Fax

Practice location:
  • Phone: 215-457-3667
  • Fax: 215-457-4381
Mailing address:
  • Phone: 215-457-3667
  • Fax: 215-457-4381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StatePA

VIII. Authorized Official

Name: DAVID W ROSSI
Title or Position: CEO
Credential:
Phone: 215-457-3667