Provider Demographics
NPI:1124424726
Name:EMBARK HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:EMBARK HOME HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-808-7173
Mailing Address - Street 1:101 N WOODLAND BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-4245
Mailing Address - Country:US
Mailing Address - Phone:407-808-7173
Mailing Address - Fax:407-542-1505
Practice Address - Street 1:101 N WOODLAND BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-4245
Practice Address - Country:US
Practice Address - Phone:407-808-7173
Practice Address - Fax:407-542-1505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-08
Last Update Date:2014-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299994162251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health