Emanuel Support Services, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

EMANUEL SUPPORT SERVICES, INC

Practice address

35 W Tillman Ave
Lake Wales, FL 33853-4179

Phone

(863) 651-7596

NPI assigned

Mar 12, 2022

Last updated

Mar 12, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gloria Shunita Lonton

Title

President

Phone

(863) 651-7596

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647043200000",
    "number": "1063160737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 W TILLMAN AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534179",
            "telephone_number": "863-651-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 W TILLMAN AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534179",
            "telephone_number": "863-651-7596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANUEL SUPPORT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-12",
        "last_updated": "2022-03-12",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "LONTON",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "SHUNITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-651-7596",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.