=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891629036
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMBASSY HOME CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2026
-----------------------------------------------------
Last Update Date | 06/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 740 S PEAR ORCHARD RD
-----------------------------------------------------
City | RIDGELAND
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39157-5101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-790-1260
-----------------------------------------------------
Fax | 601-605-7060
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 740 S PEAR ORCHARD RD
-----------------------------------------------------
City | RIDGELAND
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39157-5101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-790-1260
-----------------------------------------------------
Fax | 601-605-7060
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | LAWANDA L KIRKLAND
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 601-790-1260
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------