Healthcare Provider Details
I. General information
NPI: 1780196915
Provider Name (Legal Business Name): EMPOWERING HOME SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/27/2017
Last Update Date: 08/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
66 S ST NW
WASHINGTON DC
20001-1128
US
IV. Provider business mailing address
114 EMORY WOODS CT
GAITHERSBURG MD
20877-3540
US
V. Phone/Fax
- Phone: 202-680-9551
- Fax: 240-474-5944
- Phone: 202-680-9951
- Fax: 240-474-5944
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | DC |
VIII. Authorized Official
Name: MR.
NELSON
PEAY
Title or Position: CEO
Credential:
Phone: 202-680-9951