Provider Demographics
NPI:1023508405
Name:AMBASSADOR HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:AMBASSADOR HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CONTRACT DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-888-2844
Mailing Address - Street 1:3333 S CONGRESS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-7300
Mailing Address - Country:US
Mailing Address - Phone:352-701-1723
Mailing Address - Fax:352-701-1770
Practice Address - Street 1:4048 DELTONA BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606
Practice Address - Country:US
Practice Address - Phone:352-701-1723
Practice Address - Fax:352-701-1770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMBASSADOR HEALTH SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-11
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103904700Medicaid
FL108173000Medicaid
FL299994849OtherAHCA