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General NPI Number Information
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NPI Number | 1962902551
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Entity Type | Organization
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Legal Business Name | IMMANUEL HOME CARE, INC
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 317 OLD HIGHWAY 431 STE C
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City | OWENS CROSS ROADS
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State | AL
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Zip | 35763-9265
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Country | US
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Telephone | 256-716-9940
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Fax | 256-716-9181
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Provider Business Mailing Address
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Address Line | 317 OLD HIGHWAY 431 STE C
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City | OWENS CROSS ROADS
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State | AL
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Zip | 35763-9265
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Country | US
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Telephone | 256-716-9940
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Fax | 256-716-9181
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Authorized Official
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Title or Position | OWNER-DIRECTOR OF OPERATIONS
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Name | GLERIA ANDERSON
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Credential |
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Telephone | 256-929-8358
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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 |
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