=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205746435
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMM LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/10/2026
-----------------------------------------------------
Last Update Date | 09/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 245 S 19TH STREET CT
-----------------------------------------------------
City | MARION
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52302-4142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-777-1748
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 245 S 19TH STREET CT
-----------------------------------------------------
City | MARION
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52302-4142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-777-1748
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. ETHERTON MUCHIRAHONDO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 319-777-1748
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------