Provider Demographics
NPI:1578178588
Name:EMMANUEL HOMECARE, INC.
Entity Type:Organization
Organization Name:EMMANUEL HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LATSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-539-0953
Mailing Address - Street 1:12551 HASHANLI PL
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-3401
Mailing Address - Country:US
Mailing Address - Phone:919-539-0953
Mailing Address - Fax:
Practice Address - Street 1:12551 HASHANLI PL
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-3401
Practice Address - Country:US
Practice Address - Phone:919-539-0953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health