Healthcare Provider Details

I. General information

NPI: 1154109304
Provider Name (Legal Business Name): HEALTH EMPOWERMENT NETWORK OF MARYLAND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 68TH PLACE
SEAT PLEASANT MD
20743
US

IV. Provider business mailing address

12138 CENTRAL AVENUE, SUITE 112
MITCHVILLE MD
20621-1910
US

V. Phone/Fax

Practice location:
  • Phone: 240-435-5038
  • Fax:
Mailing address:
  • Phone: 240-435-5038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. EUGENE W. GRANT
Title or Position: PRESIDENT/CEO
Credential:
Phone: 240-435-5038