Provider Demographics
NPI:1427386572
Name:AMBASSADOR HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:AMBASSADOR HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:HEVERT
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:561-498-2743
Mailing Address - Street 1:3333 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-7308
Mailing Address - Country:US
Mailing Address - Phone:561-274-4149
Mailing Address - Fax:
Practice Address - Street 1:900 GLADES RD
Practice Address - Street 2:SUITE E1
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6421
Practice Address - Country:US
Practice Address - Phone:561-498-2743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299993576251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health