Provider Demographics
NPI:1790060747
Name:EMBRACIVE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:EMBRACIVE HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LISLE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:EVELYN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:866-437-7589
Mailing Address - Street 1:PO BOX 7565
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-0565
Mailing Address - Country:US
Mailing Address - Phone:866-437-7589
Mailing Address - Fax:888-505-5087
Practice Address - Street 1:8203 LINDBERG BAY DRIVE
Practice Address - Street 2:CYRIL E. KING AIRPORT
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-5945
Practice Address - Country:US
Practice Address - Phone:866-437-7589
Practice Address - Fax:888-505-5087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
VI1-13182-1L3416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No3416A0800XTransportation ServicesAmbulanceAir Transport