Healthcare Provider Details
I. General information
NPI: 1750222980
Provider Name (Legal Business Name): ELIZABETH EMBRACE COMMUNITY HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
73 HIDDEN BROOK BLVD
DOVER DE
19904-1896
US
IV. Provider business mailing address
73 HIDDEN BROOK BLVD
DOVER DE
19904-1896
US
V. Phone/Fax
- Phone: 215-966-9782
- Fax:
- Phone: 215-966-9782
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARAH
DAFILS
Title or Position: PROGRAM ADMINISTRATOR
Credential: RN BSN
Phone: 267-343-2839