Provider Demographics
NPI:1396851267
Name:EMBASSY HEALTHCARE SYSTEM INC
Entity Type:Organization
Organization Name:EMBASSY HEALTHCARE SYSTEM INC
Other - Org Name:EMBASSY HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MADUAKOLAM
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:UBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-589-8050
Mailing Address - Street 1:10701 CORPORATE DR
Mailing Address - Street 2:395
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4096
Mailing Address - Country:US
Mailing Address - Phone:713-589-8050
Mailing Address - Fax:281-240-3005
Practice Address - Street 1:10701 CORPORATE DR
Practice Address - Street 2:395
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4096
Practice Address - Country:US
Practice Address - Phone:713-589-8050
Practice Address - Fax:281-240-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012747251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218400401Medicaid