# EMMAUS VILLA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750017166
- **Authorized official:** JESSY PARATHUNDIL (ADMINISTRATOR)
- **Authorized official phone:** (954) 873-2561

## Contact information

- **Practice address:** 6271 NW 15TH ST, MARGATE, FL 33063-2702
- **Practice address phone:** (954) 873-2561
- **Practice address fax:** (954) 247-9560
- **Mailing address:** 6271 NW 15TH ST, MARGATE, FL 33063-2702
- **Mailing address phone:** (954) 873-2561
- **Mailing address fax:** (954) 247-9560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/27/2022
- **Last updated:** 07/27/2022