Healthcare Provider Details

I. General information

NPI: 1275852204
Provider Name (Legal Business Name): T & L EMPOWERMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2010
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S MAIN ST SUITE 5
RAEFORD NC
28376-3238
US

IV. Provider business mailing address

305 E 3RD ST STE 5
PEMBROKE NC
28372-7991
US

V. Phone/Fax

Practice location:
  • Phone: 910-875-1407
  • Fax: 910-875-1476
Mailing address:
  • Phone: 910-521-7461
  • Fax: 910-521-7463

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LORIE HAMMONDS
Title or Position: CEO/VP/DIRECTOR
Credential:
Phone: 910-521-7461