Healthcare Provider Details

I. General information

NPI: 1861035115
Provider Name (Legal Business Name): EMPOWERED CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2019
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4433 WOODSON RD STE 220A
SAINT LOUIS MO
63134-3721
US

IV. Provider business mailing address

4433 WOODSON RD STE 220A
SAINT LOUIS MO
63134-3721
US

V. Phone/Fax

Practice location:
  • Phone: 314-794-4115
  • Fax: 314-794-4116
Mailing address:
  • Phone: 314-794-4115
  • Fax: 314-794-4116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: ANNYA MOODY
Title or Position: DIRECTOR/OWNER
Credential: MSN
Phone: 314-794-4115