Organization
EMBOLDEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANTEL WOODSTOCK (OWNER)
(954) 816-9133
Entity
Organization
Contact information
Practice address
7040 FILLMORE ST, HOLLYWOOD, FL 33024-7345
(954) 816-9133
Mailing address
7040 FILLMORE ST, HOLLYWOOD, FL 33024-7345
(954) 816-9133
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
Other
Enumeration date
09/19/2023
Last updated
10/25/2023
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