Provider Demographics
NPI:1942081435
Name:EMMANUEL PROPERTIES LLC
Entity Type:Organization
Organization Name:EMMANUEL PROPERTIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERAKAH
Authorized Official - Suffix:
Authorized Official - Credentials:MSM
Authorized Official - Phone:781-820-4158
Mailing Address - Street 1:38 MARBLE ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-1954
Mailing Address - Country:US
Mailing Address - Phone:781-820-4158
Mailing Address - Fax:
Practice Address - Street 1:38 MARBLE ST UNIT 2
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-1954
Practice Address - Country:US
Practice Address - Phone:781-520-3587
Practice Address - Fax:781-626-5248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care