Healthcare Provider Details

I. General information

NPI: 1568618957
Provider Name (Legal Business Name): EMPOWERMENT GROUP HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5522 WOODBERRY RD
DURHAM NC
27707-5359
US

IV. Provider business mailing address

1905 LANDON FARMS LN
DURHAM NC
27704-4792
US

V. Phone/Fax

Practice location:
  • Phone: 919-403-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberMHL032326
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. TAMMIE HOLLINGSWORTH
Title or Position: PRESIDENT
Credential:
Phone: 919-403-6300