Provider Demographics
NPI:1972556215
Name:EMBER COMPLETE CARE INC.
Entity Type:Organization
Organization Name:EMBER COMPLETE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANDISON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:740-922-6888
Mailing Address - Street 1:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:UHRICHSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44683-0369
Mailing Address - Country:US
Mailing Address - Phone:740-922-6888
Mailing Address - Fax:740-922-6689
Practice Address - Street 1:1800 N WATER STREET EXT
Practice Address - Street 2:
Practice Address - City:UHRICHSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44683-1044
Practice Address - Country:US
Practice Address - Phone:740-922-6888
Practice Address - Fax:740-388-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2016080Medicare ID - Type Unspecified
OH367725Medicare ID - Type Unspecified