Provider Demographics
NPI:1902661754
Name:AMBASSADORS HEALTH CARE LLC
Entity Type:Organization
Organization Name:AMBASSADORS HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF/EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:LARELISA MARIE
Authorized Official - Middle Name:RAMOS
Authorized Official - Last Name:BERNARDO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT,PT
Authorized Official - Phone:609-284-5536
Mailing Address - Street 1:452 EXETER CT
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-6682
Mailing Address - Country:US
Mailing Address - Phone:609-284-5536
Mailing Address - Fax:
Practice Address - Street 1:452 EXETER CT
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-6682
Practice Address - Country:US
Practice Address - Phone:609-284-5536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health