Healthcare Provider Details

I. General information

NPI: 1902672264
Provider Name (Legal Business Name): EMBRACED HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2023
Last Update Date: 05/07/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 COLUMBIA AVE E STE F1559
BATTLE CREEK MI
49015-3737
US

IV. Provider business mailing address

30 COLUMBIA AVE E STE F1559
BATTLE CREEK MI
49015-3737
US

V. Phone/Fax

Practice location:
  • Phone: 269-569-6264
  • Fax:
Mailing address:
  • Phone: 269-569-6264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE SHACQUEL DEAN
Title or Position: CEO
Credential:
Phone: 269-569-6264