Provider Demographics
NPI:1285273656
Name:EMMANUEL ELDER CARE SERVICES LLC
Entity type:Organization
Organization Name:EMMANUEL ELDER CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-288-6677
Mailing Address - Street 1:6612 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3907
Mailing Address - Country:US
Mailing Address - Phone:443-828-7777
Mailing Address - Fax:
Practice Address - Street 1:6612 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-3907
Practice Address - Country:US
Practice Address - Phone:443-828-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care