Esperanza Primary Care & Behavior Health

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ESPERANZA PRIMARY CARE & BEHAVIOR HEALTH

Practice address

1680 Cooper Foster Park Rd W Ste C
Lorain, OH 44053-3657

Phone

(440) 444-0030

Fax

(440) 444-0113

NPI assigned

Mar 21, 2024

Last updated

Mar 21, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keishla Marie Perez Rodriguez

Title

Ceo

Phone

(440) 654-5565

Specialties & licenses 4

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1982464343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 COOPER FOSTER PARK RD W STE C",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533657",
            "telephone_number": "440-444-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 COOPER FOSTER PARK RD W STE C",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533657",
            "telephone_number": "440-444-0030",
            "fax_number": "440-444-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESPERANZA PRIMARY CARE & BEHAVIOR HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "PEREZ RODRIGUEZ",
        "authorized_official_first_name": "KEISHLA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "440-654-5565"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.