Emmanuel Residential Services

LBN: Emmanuel Residential Services
Emmanuel Residential Services is an health care organization with primary practice located at 1328 Heritage Blvd Ste 5 , Longview TX 75605-1472. The organization recently has 5 registered licenses in different health care specialties including Other Service Providers / Contractor, Agencies / Day Training, Developmentally Disabled Services, Ambulatory Health Care Facilities / Adult Day Care, Nursing & Custodial Care Facilities / Assisted Living Facility, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Nursing & Custodial Care Facilities / Assisted Living Facility is the primary health care specialty. Emmanuel Residential Services can be contacted via phone (903) 260-0412, or through Polk, La Tonya S via phone (903) 315-8302.

Contact Information

Primary practice address
1328 Heritage Blvd Ste 5 Longview TX 75605-1472
Phone: (903) 260-0412
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Polk, La Tonya S
Phone: (903) 315-8302

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Ambulatory Health Care Facilities / Adult Day Care 261QA0600X
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X

Profile Details

NPI number 1245509504
LBN Legal business name Emmanuel Residential Services
DBA Doing business as
Authorized official Polk, La Tonya S
Entity Organization
Organization subpart 1 No
Enumeration date Dec 15th, 2011
Last updated Apr 15th, 2026 - about 6 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245509504 NPPES
Texas MEDICAID 1245509504

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