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General NPI Number Information
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NPI Number | 1861007304
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Entity Type | Organization
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Legal Business Name | EMMANUEL'S PROFESSIONAL SERVICES LLC
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 6009 TORRESDALE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19135-3715
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Country | US
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Telephone | 267-388-6941
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Fax |
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Provider Business Mailing Address
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Address Line | 624 LEVICK ST
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City | PHILADELPHIA
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State | PA
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Zip | 19111-5738
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR/PRESIDENT
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Name | BEAUBRUN EMMANUEL
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Credential |
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Telephone | 267-498-8919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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