Provider Demographics
NPI:1225290299
Name:EMBRACE LIFE
Entity Type:Organization
Organization Name:EMBRACE LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-291-1499
Mailing Address - Street 1:2521 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-8629
Mailing Address - Country:US
Mailing Address - Phone:515-291-1499
Mailing Address - Fax:515-292-2184
Practice Address - Street 1:2521 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 121
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8629
Practice Address - Country:US
Practice Address - Phone:515-291-1499
Practice Address - Fax:515-292-2184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA060441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty