MEDICARE: EMBARK HOME HEALTHCARE LLC

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	:	1881037315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBARK HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	1100 TOWN PLAZA CT STE 2020
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-6231
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 TOWN PLAZA CT STE 2020
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-6231
Country	:	US
Telephone Number	:	407-808-7173
Fax Number	:

Authorized Official
Title or Position	:	BOARD MEMBER
Name	:	ROBBYN ARCAYA
Credential	:
Telephone Number	:	407-808-7173

Provider Enumeration Date	:	04/15/2013
Last Update Date	:	03/04/2014

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