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General NPI Number Information
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NPI Number | 1306933346
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Entity Type | Organization
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Legal Business Name | ESPERANZA HEALTH CENTER, INC.
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 10/17/2012
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Provider Practice Location Address
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Address Line | 2940 N. 5TH STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19133-2801
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Country | US
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Telephone | 215-221-6633
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Fax | 215-224-5644
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Provider Business Mailing Address
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Address Line | 4417 N. 6TH ST.
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City | PHILADELPHIA
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State | PA
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Zip | 19140-2319
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Country | US
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Telephone | 215-302-3600
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Fax | 215-805-8591
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. SUSAN M POST
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Credential | D.MIN., MBA
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Telephone | 215-302-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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