22D2274593 CLIA NUMBER - CASA ESPERANZA CONEXIONES

Laboratory Demographics

CLIA Number: 22D2274593

Facility Name: CASA ESPERANZA CONEXIONES

Facility Address:
365 EAST ST
TEWKSBURY, MA
ZIP 01876
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Facility Phone Number: 857 256-4983

Facility Type: Other - CONGREGATEC CARE

Certificate Type: Waiver

NPI Number: 1447769443

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	22D2274593
LAB Type	Other - CONGREGATEC CARE
Facility Name	CASA ESPERANZA CONEXIONES
Street	365 EAST ST
City	TEWKSBURY
State	MA
ZIP	01876
Phone	857 256-4983
CertificateType	4
CertificateEffectiveDate	1/6/2023
CertificateExpirationDate	1/5/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024