Healthcare Provider Details

I. General information

NPI: 1679829014
Provider Name (Legal Business Name): EMPOWERMENT & RECOVERY SERVICES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 N QUEEN ST SUITE 110
KINSTON NC
28501-4984
US

IV. Provider business mailing address

327 N QUEEN ST SUITE 110
KINSTON NC
28501-4984
US

V. Phone/Fax

Practice location:
  • Phone: 252-522-4676
  • Fax: 252-523-1685
Mailing address:
  • Phone: 252-522-4676
  • Fax: 252-523-1685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL EDWARD FOXWORTH SR.
Title or Position: CORPORATE DIRECTOR
Credential:
Phone: 252-522-4676