Provider Demographics
NPI:1043545015
Name:EMBRACE HOME CARE, LLC
Entity type:Organization
Organization Name:EMBRACE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:313-717-8238
Mailing Address - Street 1:21919 TELEGRAPH RD
Mailing Address - Street 2:UPPER SUITE 1
Mailing Address - City:BROWNSTOWN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1335
Mailing Address - Country:US
Mailing Address - Phone:313-717-8238
Mailing Address - Fax:734-307-7492
Practice Address - Street 1:21919 TELEGRAPH RD
Practice Address - Street 2:UPPER SUITE 1
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-1335
Practice Address - Country:US
Practice Address - Phone:313-717-8238
Practice Address - Fax:734-307-7492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health