Provider Demographics
NPI:1538700794
Name:EMBRACE HOME AND COMPANION SERVICES LLC
Entity Type:Organization
Organization Name:EMBRACE HOME AND COMPANION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:PROF
Authorized Official - First Name:SAQUANNA
Authorized Official - Middle Name:LATOYA
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-283-4341
Mailing Address - Street 1:3101 NE 15TH ST APT G61
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-2443
Mailing Address - Country:US
Mailing Address - Phone:352-283-4341
Mailing Address - Fax:
Practice Address - Street 1:3101 NE 15TH ST APT G61
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-2443
Practice Address - Country:US
Practice Address - Phone:352-283-4341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL236275OtherHOMEKER AND COMPANION LICENSE