Organization
EMANUEL SUPPORT SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA SHUNITA LONTON (PRESIDENT)
(863) 651-7596
Entity
Organization
Contact information
Practice address
35 W TILLMAN AVE, LAKE WALES, FL 33853-4179
(863) 651-7596
Mailing address
35 W TILLMAN AVE, LAKE WALES, FL 33853-4179
(863) 651-7596
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/12/2022
Last updated
03/12/2022
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