Provider Demographics
NPI:1205553468
Name:EMBRACE HEALTH SERVICES LLC
Entity type:Organization
Organization Name:EMBRACE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REGINAH
Authorized Official - Middle Name:MBULA
Authorized Official - Last Name:NGWILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-900-6930
Mailing Address - Street 1:3318 SPRING MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-6482
Mailing Address - Country:US
Mailing Address - Phone:214-900-6930
Mailing Address - Fax:888-229-5662
Practice Address - Street 1:3318 SPRING MEADOW LN
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-6482
Practice Address - Country:US
Practice Address - Phone:214-900-6930
Practice Address - Fax:888-229-5662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management