Healthcare Provider Details

I. General information

NPI: 1235042581
Provider Name (Legal Business Name): EMPOWER GROWTH ABA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

987 W 33RD ST
HIALEAH FL
33012-5155
US

IV. Provider business mailing address

987 W 33RD ST
HIALEAH FL
33012-5155
US

V. Phone/Fax

Practice location:
  • Phone: 786-873-1638
  • Fax:
Mailing address:
  • Phone: 786-873-1638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: LAURA CONCEPCION BLANCO
Title or Position: PRESIDENT
Credential:
Phone: 786-873-1638