Provider Demographics
NPI:1407618515
Name:ELDER EMBRACE
Entity Type:Organization
Organization Name:ELDER EMBRACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS XVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-815-1192
Mailing Address - Street 1:6818 SW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33023-1629
Mailing Address - Country:US
Mailing Address - Phone:954-815-1192
Mailing Address - Fax:
Practice Address - Street 1:6818 SW 9TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33023-1629
Practice Address - Country:US
Practice Address - Phone:954-815-1192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care