Provider Demographics
NPI:1942073226
Name:EMBRACE GROWTH HOME LLC
Entity Type:Organization
Organization Name:EMBRACE GROWTH HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIAW CHING
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-241-7217
Mailing Address - Street 1:4872 E ST JOHN RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-0018
Mailing Address - Country:US
Mailing Address - Phone:480-241-7217
Mailing Address - Fax:
Practice Address - Street 1:4872 E ST JOHN RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-0018
Practice Address - Country:US
Practice Address - Phone:480-241-7217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMBRACE GROWTH HOME LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty