Provider Demographics
NPI:1598779282
Name:EMBRACE HOME HEALTH PHYSICIANS
Entity Type:Organization
Organization Name:EMBRACE HOME HEALTH PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ELOISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORIAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-948-7985
Mailing Address - Street 1:19189 W 10 MILE RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2453
Mailing Address - Country:US
Mailing Address - Phone:248-948-7985
Mailing Address - Fax:248-948-9031
Practice Address - Street 1:19189 W 10 MILE ROAD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-948-7985
Practice Address - Fax:248-948-9031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P23590Medicare PIN