Healthcare Provider Details

I. General information

NPI: 1548790934
Provider Name (Legal Business Name): HEALTH EMPOWERMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2017
Last Update Date: 10/30/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 SWORD ST
WEST BABYLON NY
11704-2114
US

IV. Provider business mailing address

45 SWORD ST
WEST BABYLON NY
11704-2114
US

V. Phone/Fax

Practice location:
  • Phone: 631-482-0582
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EBONY WHITE
Title or Position: OWNER
Credential:
Phone: 631-223-8604