Healthcare Provider Details

I. General information

NPI: 1558035147
Provider Name (Legal Business Name): EMPOWERME ASL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 SUNSET DR
NORWALK IA
50211-1266
US

IV. Provider business mailing address

1335 STRASSNER DR
BRENTWOOD MO
63144-1872
US

V. Phone/Fax

Practice location:
  • Phone: 844-502-7996
  • Fax:
Mailing address:
  • Phone: 844-502-7996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN DAVID CHURCH
Title or Position: VICE PRESIDENT OF FINANCE
Credential:
Phone: 618-972-5228