| NPI | 1720848484 |
|---|---|
| Other Name | EMBARK VIRTUAL AT ILLINOIS |
| Entity Type | Organization |
| Authorized Contact | SHARNELL SPENCER Credentialing Manager 661-239-6923 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2025-05-21 |