1437479847 NPI number — EMBRACING HEALTH LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437479847 NPI number — EMBRACING HEALTH LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EMBRACING HEALTH LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437479847
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
385 GARRISONVILLE RD
Provider Second Line Business Mailing Address:
SUITE 211
Provider Business Mailing Address City Name:
STAFFORD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22554-1545
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-657-1223
Provider Business Mailing Address Fax Number:
540-657-1220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
385 GARRISONVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 204/211
Provider Business Practice Location Address City Name:
STAFFORD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22554-1545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-657-1223
Provider Business Practice Location Address Fax Number:
540-657-1220
Provider Enumeration Date:
06/08/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VILLARREAL
Authorized Official First Name:
YVONNE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PHYSICIAN OWNER
Authorized Official Telephone Number:
540-286-3729

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)