Healthcare Provider Details

I. General information

NPI: 1437384302
Provider Name (Legal Business Name): EMPOWERMENT QUALITY CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 02/16/2022
Certification Date: 02/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8535 CLIFF CAMERON DR STE 100
CHARLOTTE NC
28269-5909
US

IV. Provider business mailing address

8535 CLIFF CAMERON DR STE 100
CHARLOTTE NC
28269-5909
US

V. Phone/Fax

Practice location:
  • Phone: 704-717-7477
  • Fax: 704-717-7457
Mailing address:
  • Phone: 704-717-7477
  • Fax: 704-717-7457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDRE REYNOLDS
Title or Position: CEO
Credential:
Phone: 704-717-7477