Organization
CASA ESPERANZA, INC.
Active
Parent organization
CASA ESPERANZA, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CASA ESPERANZA, INC.
Authorized official
EVA JACKSON (DIRECTOR REVENUE CYCLE MANAGEMENT)
(617) 822-5594
Entity
Organization
Contact information
Practice address
291 EUSTIS ST, ROXBURY, MA 02119-2826
(617) 445-1123
Mailing address
302 EUSTIS ST, ROXBURY, MA 02119-3800
(617) 445-1123
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04298
TUFTS HEALTH PLAN
MA
05
—
110082430B
—
MA
01
—
43304
BEACON MBHP VALUE OPTION
MA
01
—
43324
BEACON HEALTH STRATEGIES
MA
Enumeration date
10/12/2018
Last updated
10/12/2018
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