Provider Demographics
NPI:1780871244
Name:EMBRACE US, INC.
Entity type:Organization
Organization Name:EMBRACE US, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CONTESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-254-1805
Mailing Address - Street 1:3719 W. MARKET ST.
Mailing Address - Street 2:STE. C
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1588
Mailing Address - Country:US
Mailing Address - Phone:336-510-4969
Mailing Address - Fax:336-547-3968
Practice Address - Street 1:3719 W MARKET ST
Practice Address - Street 2:STE. C
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1588
Practice Address - Country:US
Practice Address - Phone:336-510-4969
Practice Address - Fax:336-547-3968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102699Medicaid