Provider Demographics
NPI:1558984823
Name:EMILY RD LLC
Entity Type:Organization
Organization Name:EMILY RD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:DANCKERS
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:440-714-2629
Mailing Address - Street 1:2051 ALMA ST
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-3903
Mailing Address - Country:US
Mailing Address - Phone:440-714-2629
Mailing Address - Fax:
Practice Address - Street 1:2051 ALMA ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-3903
Practice Address - Country:US
Practice Address - Phone:440-714-2629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health