MEDICARE: EMBASSY HOME CARE, 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1891629036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMBASSY HOME CARE, LLC

Provider Business Mailing Address
First Line	:	740 S PEAR ORCHARD RD
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-5101
Country	:	US
Telephone Number	:	601-790-1260
Fax Number	:	601-605-7060

Provider Business Practice Location Address
First Line	:	740 S PEAR ORCHARD RD
Second Line	:
City	:	RIDGELAND
State	:	MS
Zip	:	39157-5101
Country	:	US
Telephone Number	:	601-790-1260
Fax Number	:	601-605-7060

Authorized Official
Title or Position	:	DIRECTOR
Name	:	LAWANDA L KIRKLAND
Credential	:	RN
Telephone Number	:	601-790-1260

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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