Healthcare Provider Details

I. General information

NPI: 1972439545
Provider Name (Legal Business Name): EMPOWER COMMUNITY SUPPORTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2749 GRAND CIR
LAWRENCE KS
66047-3753
US

IV. Provider business mailing address

2749 GRAND CIR
LAWRENCE KS
66047-3753
US

V. Phone/Fax

Practice location:
  • Phone: 785-764-2978
  • Fax:
Mailing address:
  • Phone: 785-764-2978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TIANA MICHELLE TUBBS
Title or Position: CEO
Credential:
Phone: 785-764-2978