MEDICARE: EMPOWER TO INSPIRE ADULT DAY PROGRAM, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1497339212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWER TO INSPIRE ADULT DAY PROGRAM, LLC

Provider Business Mailing Address
First Line	:	7041 READ LN
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-2366
Country	:	US
Telephone Number	:	504-354-9763
Fax Number	:	504-459-2552

Provider Business Practice Location Address
First Line	:	7041 READ LN
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-2366
Country	:	US
Telephone Number	:	504-210-9150
Fax Number	:	504-910-8604

Authorized Official
Title or Position	:	CEO
Name	:	MRS. JONEITA FONTENETTE
Credential	:
Telephone Number	:	504-210-9150

Provider Enumeration Date	:	05/07/2021
Last Update Date	:	10/27/2022

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