Provider Demographics
NPI:1912370396
Name:EMMAUS HOME INC
Entity Type:Organization
Organization Name:EMMAUS HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-378-3354
Mailing Address - Street 1:546 WANAMAKER AVE
Mailing Address - Street 2:
Mailing Address - City:ESSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19029-1118
Mailing Address - Country:US
Mailing Address - Phone:215-378-3354
Mailing Address - Fax:610-537-7626
Practice Address - Street 1:546 WANAMAKER AVE
Practice Address - Street 2:
Practice Address - City:ESSINGTON
Practice Address - State:PA
Practice Address - Zip Code:19029-1118
Practice Address - Country:US
Practice Address - Phone:215-378-3354
Practice Address - Fax:610-537-7626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA00083921251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services