Healthcare Provider Details

I. General information

NPI: 1114236205
Provider Name (Legal Business Name): EMPOWERING 2 EXCEL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2010
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7116 MANZANARES DR
N LAS VEGAS NV
89084-2345
US

IV. Provider business mailing address

7116 MANZANARES DR
N LAS VEGAS NV
89084-2345
US

V. Phone/Fax

Practice location:
  • Phone: 702-290-9398
  • Fax: 702-664-6230
Mailing address:
  • Phone: 702-290-9398
  • Fax: 702-664-6230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LORENZO REED
Title or Position: OWNER
Credential:
Phone: 702-290-9398