Healthcare Provider Details

I. General information

NPI: 1043157829
Provider Name (Legal Business Name): EMPOWER HOME CARE AGENCY,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 HARDY ST STE A
HATTIESBURG MS
39401-4902
US

IV. Provider business mailing address

1321 HARDY ST STE A
HATTIESBURG MS
39401-4902
US

V. Phone/Fax

Practice location:
  • Phone: 601-549-7346
  • Fax: 601-336-7724
Mailing address:
  • Phone: 601-549-7346
  • Fax: 601-336-7724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHIRLEY GRANDISON
Title or Position: CEO
Credential: OWNER
Phone: 601-549-7346