Organization
POSITIVE SUPPORT SERVICE
Active
Organization
POSITIVE SUPPORT SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EMBRIGE BEMBRY III (MEDICAID WAIVER PROVIDER)
(863) 845-6323
Entity
Organization
Contact information
Practice address
1046 SUMMER GLEN DR, WINTER HAVEN, FL 33880-1933
(863) 845-6323
Mailing address
1046 SUMMER GLEN DR, WINTER HAVEN, FL 33880-1933
(863) 845-6323
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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