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General NPI Number Information
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NPI Number | 1669444329
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Entity Type | Organization
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Legal Business Name | EMILY PROGRAM PC
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 8001 RAVINES EDGE CT
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City | COLUMBUS
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State | OH
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Zip | 43235-5423
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Country | US
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Telephone | 866-364-5977
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Fax | 614-896-8223
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Provider Business Mailing Address
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Address Line | 1295 BANDANA BLVD N STE 210
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City | SAINT PAUL
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State | MN
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Zip | 55108-5115
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Country | US
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Telephone | 651-645-5323
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Fax | 651-379-6105
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | KATHERINE NORRIS
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Credential | JD
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Telephone | 888-364-5977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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