Healthcare Provider Details
I. General information
NPI: 1265269195
Provider Name (Legal Business Name): EMPOWERING KULTURE SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5315 GLENFIELD DR
SAGINAW MI
48638-5428
US
IV. Provider business mailing address
186 MAPLEOAK DR
CADDO MILLS TX
75135-6595
US
V. Phone/Fax
- Phone: 989-482-7266
- Fax:
- Phone: 989-482-7266
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
KANDICE
HOPKINS
Title or Position: OWNER/CLINICAN
Credential: LLMSW,QIDP,CADC-DP
Phone: 989-482-7266