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NPI Code Detail

MEDICARE: THE EMILY PROGRAM PC

MEDICARE: THE EMILY PROGRAM PC
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
1323P00000XPsychiatric Residential Treatment Facility

General Provider Information

NPI Number : 1902203177
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE EMILY PROGRAM PC
Provider Business Mailing Address
First Line : 1295 BANDANA BLVD. W.
Second Line : SUITE 210
City : ST. PAUL
State : MN
Zip : 55108-1737
Country : US
Telephone Number : 866-364-5977
Fax Number :
Provider Business Practice Location Address
First Line : 2141 OVERLOOK RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44106-5995
Country : US
Telephone Number : 888-364-5977
Fax Number :
Authorized Official
Title or Position : GENERAL COUNSEL
Name : KATHERINE NORRIS
Credential : JD
Telephone Number : 888-364-5977
Provider Enumeration Date : 12/03/2014
Last Update Date : 01/31/2023

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Directions to “THE EMILY PROGRAM PC ” Practice Location

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