Healthcare Provider Details

I. General information

NPI: 1437365830
Provider Name (Legal Business Name): FAMILY EMPOWERMENT ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 W JIMMIE LEEDS RD STE 305
GALLOWAY NJ
08205-9418
US

IV. Provider business mailing address

76 W JIMMIE LEEDS RD STE 305
GALLOWAY NJ
08205-9418
US

V. Phone/Fax

Practice location:
  • Phone: 609-916-6500
  • Fax: 609-798-0112
Mailing address:
  • Phone: 609-916-6500
  • Fax: 609-798-0112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LEXA MORENO
Title or Position: HR MANAGER
Credential:
Phone: 609-916-6500