Healthcare Provider Details

I. General information

NPI: 1467837104
Provider Name (Legal Business Name): EMPOWER U.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2015
Last Update Date: 07/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SILVERS RD
MARLBORO NJ
07746-1800
US

IV. Provider business mailing address

1 SILVERS RD
MARLBORO NJ
07746-1800
US

V. Phone/Fax

Practice location:
  • Phone: 908-907-7777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0019810
License Number StateNJ

VIII. Authorized Official

Name: MRS. ELIZABETH GRAY
Title or Position: MANAGING PARTNER
Credential: RN
Phone: 732-308-3639