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General NPI Number Information
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NPI Number | 1508029133
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Entity Type | Organization
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Legal Business Name | EMILY ANNE CENTER, INC
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 8679 CANTERBURY AVE
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4063
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Country | US
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Telephone | 818-781-7244
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Fax | 818-781-7836
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Provider Business Mailing Address
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Address Line | 8679 CANTERBURY AVE
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4063
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Country | US
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Telephone | 818-781-7244
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Fax | 818-781-7836
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Authorized Official
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Title or Position | OWNER/LICENSEE
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Name | MRS. EMMA P ARALAR
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Credential |
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Telephone | 818-781-7244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 550000627
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License Number State | CA
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