MEDICARE: EMBRACE HEALTHCARE SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1407439631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBRACE HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	2945 STONE HOGAN CONNECTOR RD SW STE 212
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-2839
Country	:	US
Telephone Number	:	404-205-5269
Fax Number	:

Provider Business Practice Location Address
First Line	:	2945 STONE HOGAN CONNECTOR RD SW STE 212
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-2839
Country	:	US
Telephone Number	:	404-205-5269
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KISMA FOREMAN
Credential	:
Telephone Number	:	678-334-5822

Provider Enumeration Date	:	05/05/2021
Last Update Date	:	05/05/2021

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