Provider Demographics
NPI:1548905086
Name:ESSENTIAL EMBRACE HEALING LLC
Entity type:Organization
Organization Name:ESSENTIAL EMBRACE HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-630-2036
Mailing Address - Street 1:529 HUFFMAN RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35215-8314
Mailing Address - Country:US
Mailing Address - Phone:205-693-8309
Mailing Address - Fax:205-213-7001
Practice Address - Street 1:1025 23RD ST S STE 379
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2499
Practice Address - Country:US
Practice Address - Phone:205-693-8309
Practice Address - Fax:205-213-7001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-29
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1041C0700XOtherTAXONOMY