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Organization

EMBRACE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. JULIE KALAMBOKIDIS MFCS, LBSW (EXECUTIVE DIRECTOR)
(712) 527-5747
Entity
Organization

Contact information

Practice address
502 SHARP ST, GLENWOOD, IA 51534-1731
(712) 527-5747
(712) 527-2091
Mailing address
502 SHARP ST, GLENWOOD, IA 51534-1731
(712) 527-5747
(712) 527-2091

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
372600000X
Adult Companion
385H00000X
Respite Care
385HR2050X
Respite Care Camp

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
X000104085
IA NPI ASSIGNED NUMBER FOR REMEDIAL SERVICES
IA
01
X000203108
IA MEDICAID HCBS SERVICES
IA
Enumeration date
01/11/2011
Last updated
01/11/2011
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