=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831412204
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ESPERANZA HACIA UN NUEVO AMANECER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/12/2010
-----------------------------------------------------
Last Update Date | 03/12/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | URB. EL VERDE C/VENUS #19
-----------------------------------------------------
City | CAGUAS
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-645-4194
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PMB 522 BOX 1283
-----------------------------------------------------
City | SAN LORENZO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 939-645-4194
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMISTRADORA / PROPIETARIA
-----------------------------------------------------
Name | VILMA IRIS RAMIREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 939-645-4194
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------