Healthcare Provider Details
I. General information
NPI: 1487147187
Provider Name (Legal Business Name): EMPOWERED HEALTH CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2018
Last Update Date: 06/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2755 DENMARK RD
COLUMBUS OH
43232-4635
US
IV. Provider business mailing address
2755 DENMARK RD
COLUMBUS OH
43232-4635
US
V. Phone/Fax
- Phone: 614-622-4086
- Fax:
- Phone: 614-622-4086
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MISS
TEEYONNA
CHARLEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 614-622-4086