Organization
LA CASA DE ESPERANZA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANSELMO VILLARREAL (EXECUTIVE DIRECTOR)
(262) 547-0887
Entity
Organization
Contact information
Practice address
210 NW BARSTOW ST, SUITE 110, WAUKESHA, WI 53188-3771
(262) 928-4402
(262) 928-7340
Mailing address
210 NW BARSTOW ST, WAUKESHA, WI 53188-3771
(262) 928-4402
(262) 928-7340
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1485
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1485
—
WI
Enumeration date
05/05/2008
Last updated
01/09/2012
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