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General NPI Number Information
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NPI Number | 1295112928
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Entity Type | Organization
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Legal Business Name | EMMANUEL UNIQUE OUTREACH PARTNERS
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 05/01/2015
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Provider Practice Location Address
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Address Line | 17960 ADELANTO RD
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City | ADELANTO
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State | CA
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Zip | 92301-1708
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Country | US
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Telephone | 760-530-9173
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Fax | 760-530-9173
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Provider Business Mailing Address
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Address Line | PO BOX 1481
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City | ADELANTO
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State | CA
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Zip | 92301-1144
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Country | US
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Telephone | 760-530-9173
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Fax | 760-530-9173
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAY PAYTON
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Credential |
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Telephone | 951-279-0031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | N7880803
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License Number State | CA
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