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General NPI Number Information
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NPI Number | 1700924685
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Entity Type | Organization
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Legal Business Name | EMMA'S HARVEST HOME
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 772 SULLIVAN AVE
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City | MOBILE
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State | AL
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Zip | 36606-2241
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Country | US
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Telephone | 251-478-8768
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Fax | 251-478-8590
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Provider Business Mailing Address
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Address Line | 772 SULLIVAN AVE P. O. BOX 6121
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City | MOBILE
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State | AL
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Zip | 36606-2241
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Country | US
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Telephone | 251-478-8768
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Fax | 251-478-8590
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. EMMA JEAN PERRYMAN
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Credential |
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Telephone | 251-478-8768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | AL
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