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NPI Code Detail

MEDICARE: NUEVA ESPERANZA LLC

MEDICARE: NUEVA ESPERANZA LLC
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
1261QM0855XAdolescent and Children Mental Health Clinic/Center4322OK

General Provider Information

NPI Number : 1134642820
Entity Type Code : Organization
Provider Name (Legal Business Name) : NUEVA ESPERANZA LLC
Provider Business Mailing Address
First Line : 1601 SW 89TH ST STE D200
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-6383
Country : US
Telephone Number : 918-215-9626
Fax Number : 405-602-0918
Provider Business Practice Location Address
First Line : 1601 SW 89TH ST STE D200
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-6383
Country : US
Telephone Number : 918-215-9626
Fax Number : 405-602-0918
Authorized Official
Title or Position : OWNER/PSYCHOTHERAPIST
Name : PATRICIA CHAVEZ ANAYA
Credential : MHR, LPC-S
Telephone Number : 918-215-9626
Provider Enumeration Date : 07/25/2017
Last Update Date : 07/21/2022

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Directions to “NUEVA ESPERANZA LLC ” Practice Location

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