Emmanuel Living and Activity Centers, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

EMMANUEL LIVING AND ACTIVITY CENTERS, LLC

Practice address

205 E US Highway 80
White Oak, TX 75693-2103

Phone

(903) 315-8302

NPI assigned

Sep 24, 2020

Last updated

Sep 24, 2020By 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

Tony Polk

Title

Member

Phone

(903) 315-8302

Specialties & licenses 4

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Latonya Polk

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Longview, TX
  • NPI 1861551814

  Home Health

  NPD

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1235746272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8664",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756078664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E US HIGHWAY 80",
            "city": "WHITE OAK",
            "state": "TX",
            "postal_code": "756932103",
            "telephone_number": "903-315-8302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 S Mobberly Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756022037",
            "country_code": "US",
            "telephone_number": "903-315-8302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMMANUEL LIVING AND ACTIVITY CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "903-315-8302"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Longview",
            "affiliation": "N",
            "address_1": "205 E US Highway 80",
            "city": "White Oak",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756932103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• DCS Medical PA (Integrity Urgent Care)
• Laramie Diane Forbes, PHARMD
• Bailey C Glenn
• Kelly Gonzalez
• Rhoshunda Yvette Hartfield, LCSW,LCDC
• Marlo Hood

• Adult Day Care Clinic/Center in White Oak, TX
• Providers in White Oak, TX by specialty
• Adult Day Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.