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NPI Code Detail

MEDICARE: HOPE LIVES - VIVE LA ESPERANZA

MEDICARE: HOPE LIVES - VIVE LA ESPERANZA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1063850824
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOPE LIVES - VIVE LA ESPERANZA
Provider Business Mailing Address
First Line : 1551 W VAN BUREN ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85007-2413
Country : US
Telephone Number : 480-208-4010
Fax Number : 602-388-1567
Provider Business Practice Location Address
First Line : 145 LAKE HAVASU AVE N
Second Line :
City : LAKE HAVASU CITY
State : AZ
Zip : 86403-5616
Country : US
Telephone Number : 480-208-4010
Fax Number : 602-388-1567
Authorized Official
Title or Position : CEO
Name : DEBRA KURKOSKI
Credential :
Telephone Number : 480-208-4010
Provider Enumeration Date : 06/13/2013
Last Update Date : 02/09/2023

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Directions to “HOPE LIVES - VIVE LA ESPERANZA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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