Provider Demographics
NPI:1770182115
Name:EMMANUEL HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:EMMANUEL HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:443-288-6677
Mailing Address - Street 1:8174 LARK BROWN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6426
Mailing Address - Country:US
Mailing Address - Phone:443-288-6677
Mailing Address - Fax:
Practice Address - Street 1:8174 LARK BROWN RD STE 201
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6426
Practice Address - Country:US
Practice Address - Phone:443-288-6677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-17
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD566703700Medicaid
MD66703700Medicaid