Provider Demographics
NPI:1538673736
Name:THE HOUSE OF EMMANUEL, INC.
Entity Type:Organization
Organization Name:THE HOUSE OF EMMANUEL, INC.
Other - Org Name:HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-944-8845
Mailing Address - Street 1:701 TALL PINES DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-8331
Mailing Address - Country:US
Mailing Address - Phone:419-944-8845
Mailing Address - Fax:
Practice Address - Street 1:350 S. IRWIN RD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-8331
Practice Address - Country:US
Practice Address - Phone:419-944-8845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management