Healthcare Provider Details

I. General information

NPI: 1740075977
Provider Name (Legal Business Name): EMPOWER COMMUNITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 CHESTER AVE FL 4
PROVIDENCE RI
02907-1245
US

IV. Provider business mailing address

136 CHESTER AVE FL 4
PROVIDENCE RI
02907-1245
US

V. Phone/Fax

Practice location:
  • Phone: 401-425-1000
  • Fax:
Mailing address:
  • Phone: 401-425-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. SUENELLY CORTES
Title or Position: CEO
Credential: CCHW, PBT, CMA
Phone: 401-492-3547