Provider Demographics
NPI:1447372743
Name:AMBASSADORS HOME CARE SERVICES, INC
Entity type:Organization
Organization Name:AMBASSADORS HOME CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:POWLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-272-8038
Mailing Address - Street 1:PO BOX 2355
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28359-2355
Mailing Address - Country:US
Mailing Address - Phone:910-272-8038
Mailing Address - Fax:910-272-8039
Practice Address - Street 1:204 E 5TH ST
Practice Address - Street 2:SUITE 101 & 102
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-5576
Practice Address - Country:US
Practice Address - Phone:910-272-8038
Practice Address - Fax:910-272-8039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3088251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408555Medicaid