Provider Demographics
NPI:1750649505
Name:EMERALD HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:EMERALD HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:EGO
Authorized Official - Last Name:OPARA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:404-643-7622
Mailing Address - Street 1:4650 MILLENIUM VIEW CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-7747
Mailing Address - Country:US
Mailing Address - Phone:404-643-7622
Mailing Address - Fax:770-922-5118
Practice Address - Street 1:4650 MILLENIUM VIEW CT
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-7747
Practice Address - Country:US
Practice Address - Phone:404-643-7622
Practice Address - Fax:770-922-5118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067-R-0821251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care