Provider Demographics
NPI:1700924685
Name:EMMA'S HARVEST HOME
Entity Type:Organization
Organization Name:EMMA'S HARVEST HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:PERRYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-478-8768
Mailing Address - Street 1:772 SULLIVAN AVE
Mailing Address - Street 2:P. O. BOX 6121
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-2241
Mailing Address - Country:US
Mailing Address - Phone:251-478-8768
Mailing Address - Fax:251-478-8590
Practice Address - Street 1:772 SULLIVAN AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-2241
Practice Address - Country:US
Practice Address - Phone:251-478-8768
Practice Address - Fax:251-478-8590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility