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General NPI Number Information
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NPI Number | 1316350788
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Entity Type | Organization
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Legal Business Name | ESPERANZA
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 06/03/2014
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Provider Practice Location Address
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Address Line | 170 E 107TH ST
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City | NEW YORK
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State | NY
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Zip | 10029-3905
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Country | US
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Telephone | 212-722-7507
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Fax | 212-722-7583
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Provider Business Mailing Address
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Address Line | 2006 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10035-1217
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Country | US
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Telephone | 212-979-8800
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Fax | 212-979-8917
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MARK HURWITZ
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Credential |
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Telephone | 212-979-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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