MEDICARE: EMMAUS HOMEHEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1144760307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMMAUS HOMEHEALTH LLC

Provider Business Mailing Address
First Line	:	2417 GREAT BEAR LN
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-2908
Country	:	US
Telephone Number	:	940-595-1460
Fax Number	:	940-891-0772

Provider Business Practice Location Address
First Line	:	2417 GREAT BEAR LN
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-2908
Country	:	US
Telephone Number	:	940-595-1460
Fax Number	:	940-891-0772

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	NELLY SANG
Credential	:
Telephone Number	:	940-595-1460

Provider Enumeration Date	:	03/07/2017
Last Update Date	:	03/07/2017

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Directions to “EMMAUS HOMEHEALTH LLC ” Practice Location

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