Healthcare Provider Details

I. General information

NPI: 1891629036
Provider Name (Legal Business Name): EMBASSY HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S PEAR ORCHARD RD
RIDGELAND MS
39157-5101
US

IV. Provider business mailing address

740 S PEAR ORCHARD RD
RIDGELAND MS
39157-5101
US

V. Phone/Fax

Practice location:
  • Phone: 601-790-1260
  • Fax: 601-605-7060
Mailing address:
  • Phone: 601-790-1260
  • Fax: 601-605-7060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LAWANDA L KIRKLAND
Title or Position: DIRECTOR
Credential: RN
Phone: 601-790-1260