Provider Demographics
NPI:1871948257
Name:THE EMILY PROGRAM, PC
Entity type:Organization
Organization Name:THE EMILY PROGRAM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:866-364-5977
Mailing Address - Street 1:1295 BANDANA BLVD N STE 210
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-5115
Mailing Address - Country:US
Mailing Address - Phone:866-364-5977
Mailing Address - Fax:
Practice Address - Street 1:4 NICKERSON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-1651
Practice Address - Country:US
Practice Address - Phone:651-645-5323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility