Healthcare Provider Details

I. General information

NPI: 1801633284
Provider Name (Legal Business Name): EMMANUEL CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 HANGAR DR
OKLAHOMA CITY OK
73108-3521
US

IV. Provider business mailing address

982 HANGAR DR
OKLAHOMA CITY OK
73108-3521
US

V. Phone/Fax

Practice location:
  • Phone: 918-360-2989
  • Fax:
Mailing address:
  • Phone: 918-360-2989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE L WILLIAMS
Title or Position: OWNER
Credential: REGISTERED NURSE
Phone: 918-360-2989