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General NPI Number Information
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NPI Number | 1023374915
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Entity Type | Organization
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Legal Business Name | EMBRACE SERVICES NC
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1801 N TRYON ST SUITE 324
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City | CHARLOTTE
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State | NC
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Zip | 28206-2704
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Country | US
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Telephone | 704-490-0877
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Fax |
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Provider Business Mailing Address
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Address Line | 4720 NIJINSKY CT
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City | CHARLOTTE
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State | NC
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Zip | 28216-5796
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Country | US
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Telephone | 704-490-0877
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Fax |
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Authorized Official
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Title or Position | OWNER/ DIRECTOR
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Name | MS. SABRINA JOHNSON
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Credential | BSQP
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Telephone | 704-490-0877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State | NC
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