Provider Demographics
NPI:1487396081
Name:HOPE ESPERANZA RESTORATION AND EMPOWERMENT CENTER, INC
Entity type:Organization
Organization Name:HOPE ESPERANZA RESTORATION AND EMPOWERMENT CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:IESHA
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROSENBORO
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LCPC
Authorized Official - Phone:301-818-1413
Mailing Address - Street 1:11288 BURBERRY ST
Mailing Address - Street 2:OPTIONAL
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695
Mailing Address - Country:US
Mailing Address - Phone:301-818-1413
Mailing Address - Fax:
Practice Address - Street 1:2 INDUSTRIAL PARK DR STE C
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2729
Practice Address - Country:US
Practice Address - Phone:301-792-7207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
No251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty