MEDICARE: EMMA'S HOUSE

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	385H00000X	Respite Care

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NA	OTHER		ADULT DAY PROGRAM

General Provider Information

NPI Number	:	1558851188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMMA'S HOUSE

Provider Business Mailing Address
First Line	:	920 BLUEBONNET DR STE 101
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75060-4501
Country	:	US
Telephone Number	:	872-839-1502
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 BLUEBONNET DR STE 101
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75060-4501
Country	:	US
Telephone Number	:	872-839-1502
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DEBBIE ELIZONDO
Credential	:
Telephone Number	:	972-839-1502

Provider Enumeration Date	:	05/18/2018
Last Update Date	:	05/18/2018

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Directions to “EMMA'S HOUSE ” Practice Location

Language	Start Address	Practice Location

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