Provider Demographics
NPI:1891236808
Name:EMMANUEL HOME CARE SERVICES INC
Entity Type:Organization
Organization Name:EMMANUEL HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTA
Authorized Official - Prefix:MRS
Authorized Official - First Name:YAHAIRA
Authorized Official - Middle Name:CONDE
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-238-1401
Mailing Address - Street 1:1422 CALLE SAN JACINTO
Mailing Address - Street 2:URB ALTAMESA APT 1B
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-238-1401
Mailing Address - Fax:
Practice Address - Street 1:1422 CALLE SAN JACINTO
Practice Address - Street 2:URB ALTAMESA APT 1B
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-238-1401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization