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General NPI Number Information
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NPI Number | 1689907933
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Entity Type | Organization
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Legal Business Name | EMERALD HOME HEALTHCARE, INC.
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Dates
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Enumeration Date | 09/17/2009
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 3923 LAKE WORTH RD SUITE 112
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City | LAKE WORTH
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State | FL
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Zip | 33461-4049
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Country | US
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Telephone | 561-304-4478
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Fax | 561-304-4479
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Provider Business Mailing Address
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Address Line | 3923 LAKE WORTH RD SUITE 112
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City | LAKE WORTH
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State | FL
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Zip | 33461-4049
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Country | US
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Telephone | 561-304-4478
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Fax | 561-304-4479
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. AVIS SPRADLEY STEPHENS
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Credential | RN
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Telephone | 561-304-4478
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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 | 299993567
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License Number State | FL
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