Provider Demographics
NPI:1891178240
Name:EMBRACECARE
Entity Type:Organization
Organization Name:EMBRACECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BERMANE
Authorized Official - Middle Name:
Authorized Official - Last Name:JEANLOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DODD PROVIDER
Authorized Official - Phone:614-359-3618
Mailing Address - Street 1:5707 FOREST ELM LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3728
Mailing Address - Country:US
Mailing Address - Phone:614-359-3618
Mailing Address - Fax:
Practice Address - Street 1:5707 FOREST ELM LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3728
Practice Address - Country:US
Practice Address - Phone:614-359-3618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSS720863172A00000X
OH253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No172A00000XOther Service ProvidersDriverGroup - Single Specialty