Provider Demographics
NPI:1558076299
Name:EMMANUEL CHRISTIAN CENTER, INC.
Entity Type:Organization
Organization Name:EMMANUEL CHRISTIAN CENTER, INC.
Other - Org Name:HOUSE OF HOPE GROUP HOME NC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OMEGA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH-PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:240-675-6145
Mailing Address - Street 1:15029 WALKING STICK WAY
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-3116
Mailing Address - Country:US
Mailing Address - Phone:240-675-6145
Mailing Address - Fax:
Practice Address - Street 1:400 SW RAILROAD ST
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:NC
Practice Address - Zip Code:27823-1644
Practice Address - Country:US
Practice Address - Phone:240-675-6145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Multi-Specialty