Provider Demographics
NPI:1356506497
Name:EMMAUS HOMES, INC.
Entity Type:Organization
Organization Name:EMMAUS HOMES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALEXANDER-WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:636-534-5200
Mailing Address - Street 1:2200 RANDOLPH STREET
Mailing Address - Street 2:
Mailing Address - City:ST. CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-0896
Mailing Address - Country:US
Mailing Address - Phone:636-534-5200
Mailing Address - Fax:636-947-1336
Practice Address - Street 1:2200 RANDOLPH STREET
Practice Address - Street 2:
Practice Address - City:ST. CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-0896
Practice Address - Country:US
Practice Address - Phone:636-534-5200
Practice Address - Fax:636-947-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO856397401Medicaid