Organization
EMMAUS VILLA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSY PARATHUNDIL (ADMINISTRATOR)
(954) 873-2561
Entity
Organization
Contact information
Practice address
6271 NW 15TH ST, MARGATE, FL 33063-2702
(954) 873-2561
(954) 247-9560
Mailing address
6271 NW 15TH ST, MARGATE, FL 33063-2702
(954) 873-2561
(954) 247-9560
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012183500
—
FL
Enumeration date
07/27/2022
Last updated
07/27/2022
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