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General NPI Number Information
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NPI Number | 1548905086
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Entity Type | Organization
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Legal Business Name | ESSENTIAL EMBRACE HEALING LLC
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Dates
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Enumeration Date | 04/29/2022
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 1025 23RD ST S STE 379
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City | BIRMINGHAM
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State | AL
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Zip | 35205-2499
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Country | US
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Telephone | 205-693-8309
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Fax | 205-213-7001
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Provider Business Mailing Address
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Address Line | 529 HUFFMAN RD
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City | BIRMINGHAM
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State | AL
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Zip | 35215-8314
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Country | US
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Telephone | 205-693-8309
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Fax | 205-213-7001
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. JACQUELINE SANDERS
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Credential |
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Telephone | 502-630-2036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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