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General NPI Number Information
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NPI Number | 1356192215
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Entity Type | Organization
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Legal Business Name | EMMARIE BEHAVIORAL HOME CARE. LLC
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 7204 W PUEBLO AVE
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City | PHOENIX
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State | AZ
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Zip | 85043-2037
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Country | US
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Telephone | 623-936-0457
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Fax | 602-583-7082
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Provider Business Mailing Address
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Address Line | 1638 E GREENWAY RD
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City | PHOENIX
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State | AZ
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Zip | 85042-5788
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Country | US
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Telephone | 602-481-9789
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EMMANUEL ADE EPIE
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Credential |
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Telephone | 623-936-0457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number |
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License Number State |
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