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General NPI Number Information
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NPI Number | 1518229681
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Entity Type | Organization
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Legal Business Name | EMANUEL UNLIMITED
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 123 CARRIE AVE
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City | CRYSTAL SPRINGS
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State | MS
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Zip | 39059-2208
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Country | US
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Telephone | 832-498-5962
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Fax |
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Provider Business Mailing Address
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Address Line | 123 CARRIE AVE
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City | CRYSTAL SPRINGS
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State | MS
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Zip | 39059-2208
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Country | US
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Telephone | 832-498-5962
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Fax |
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Authorized Official
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Title or Position | AGENCY DIRECTOR
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Name | MR. KENYON M ANDERSON
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Credential | MBA/HCM
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Telephone | 832-498-5962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MS
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