Healthcare Provider Details

I. General information

NPI: 1508738295
Provider Name (Legal Business Name): EMPOWER U AUTISM SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 MONMOUTH ST FL 3
RED BANK NJ
07701-1634
US

IV. Provider business mailing address

612 CORPORATE WAY STE 2M
VALLEY COTTAGE NY
10989-2027
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARLON GRAY
Title or Position: OWNER
Credential:
Phone: 908-907-7777