Provider Demographics
NPI:1962641787
Name:EMMA CENTER INC
Entity Type:Organization
Organization Name:EMMA CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNTBAUSE
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:SLONE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:602-249-2996
Mailing Address - Street 1:4117 N 17TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5921
Mailing Address - Country:US
Mailing Address - Phone:602-266-0887
Mailing Address - Fax:602-266-0881
Practice Address - Street 1:4117 N 17TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-5921
Practice Address - Country:US
Practice Address - Phone:602-266-0887
Practice Address - Fax:602-266-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency