Healthcare Provider Details

I. General information

NPI: 1386037521
Provider Name (Legal Business Name): EMANUEL LOVING ARMS RESIDENTIAL CHILD CARE , INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2015
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 SABREENA CIR
HINESVILLE GA
31313-8204
US

IV. Provider business mailing address

243 SABREENA CIR
HINESVILLE GA
31313-8204
US

V. Phone/Fax

Practice location:
  • Phone: 877-732-3277
  • Fax:
Mailing address:
  • Phone: 877-732-3277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. CHERYL ANN TAPPER
Title or Position: VICE PRESIDENT /CFO
Credential: MASTERS
Phone: 302-559-3572