Provider Demographics
NPI:1508029133
Name:EMILY ANNE CENTER, INC
Entity Type:Organization
Organization Name:EMILY ANNE CENTER, INC
Other - Org Name:EMILY ANNE HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/LICENSEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:P
Authorized Official - Last Name:ARALAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-781-7244
Mailing Address - Street 1:8679 CANTERBURY AVE
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4063
Mailing Address - Country:US
Mailing Address - Phone:818-781-7244
Mailing Address - Fax:818-781-7836
Practice Address - Street 1:8679 CANTERBURY AVE
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4063
Practice Address - Country:US
Practice Address - Phone:818-781-7244
Practice Address - Fax:818-781-7836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000627320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities