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General NPI Number Information
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NPI Number | 1407526627
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Entity Type | Organization
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Legal Business Name | EMMAUS CORPORATION
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Dates
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Enumeration Date | 09/18/2021
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Last Update Date | 09/18/2021
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Provider Practice Location Address
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Address Line | 2447 N WILLIAMSTON RD
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City | WILLIAMSTON
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State | MI
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Zip | 48895-9462
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Country | US
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Telephone | 517-655-8953
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Fax | 517-655-8954
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Provider Business Mailing Address
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Address Line | 1600 E GRAND RIVER AVE OFC
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City | EAST LANSING
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State | MI
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Zip | 48823-3910
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Country | US
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Telephone | 517-410-8249
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | DANA LYNN TRYON
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Credential |
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Telephone | 517-410-8249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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