Provider Demographics
NPI:1326647165
Name:EMA REHABILITATION, LLC
Entity type:Organization
Organization Name:EMA REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE AND OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CHURCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-925-0880
Mailing Address - Street 1:300 HUNTER AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-2328
Mailing Address - Country:US
Mailing Address - Phone:636-279-5080
Mailing Address - Fax:
Practice Address - Street 1:1831 E KANESVILLE BLVD
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-4767
Practice Address - Country:US
Practice Address - Phone:712-322-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility