Healthcare Provider Details

I. General information

NPI: 1962367409
Provider Name (Legal Business Name): EMPOWERED LIVING CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1146 14TH ST
DES MOINES IA
50314-2274
US

IV. Provider business mailing address

1146 14TH ST
DES MOINES IA
50314-2274
US

V. Phone/Fax

Practice location:
  • Phone: 515-783-6689
  • Fax:
Mailing address:
  • Phone: 515-783-6689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KNYA STEWART
Title or Position: MANAGING MEMBER
Credential:
Phone: 515-783-6689