| La Casa De Esperanza | |
|
210 Nw Barstow St Suite 110 Waukesha WI 53188-3771 | |
| (262) 928-4402 | |
| (262) 928-7340 |
| Full Name | La Casa De Esperanza |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 210 Nw Barstow St, Waukesha, Wisconsin |
| Authorized Official Name and Position | Anselmo Villarreal (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2625470887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Casa De Esperanza 210 Nw Barstow St Waukesha WI 53188-3771 Ph: (262) 928-4402 | La Casa De Esperanza 210 Nw Barstow St Suite 110 Waukesha WI 53188-3771 Ph: (262) 928-4402 |
| NPI Number | 1073789541 |
|---|---|
| Provider Enumeration Date | 05/05/2008 |
| Last Update Date | 01/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073789541 | NPI | - | NPPES |
| 1485 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1485 (Wisconsin) | Primary |
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