Provider Demographics
NPI:1477843209
Name:EMBRACE HOME CARE LLC
Entity Type:Organization
Organization Name:EMBRACE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MADRIGAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:507-369-5701
Mailing Address - Street 1:204 S WASHINGTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-2555
Mailing Address - Country:US
Mailing Address - Phone:507-369-5701
Mailing Address - Fax:507-369-5702
Practice Address - Street 1:204 S WASHINGTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-2555
Practice Address - Country:US
Practice Address - Phone:507-369-5701
Practice Address - Fax:507-369-5702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN35226251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA522457100Medicaid
MNA697988100Medicaid
MN1477843209Medicaid