Healthcare Provider Details

I. General information

NPI: 1427911049
Provider Name (Legal Business Name): EMPOWERING FAMILIES OF SOUTH CAROLINA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

161 BROMLEY VILLAGE DR UNIT 201
FORT MILL SC
29708-7049
US

IV. Provider business mailing address

161 BROMLEY VILLAGE DR UNIT 201
FORT MILL SC
29708-7049
US

V. Phone/Fax

Practice location:
  • Phone: 803-493-9389
  • Fax:
Mailing address:
  • Phone: 803-493-9389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: EBONY D GRAY
Title or Position: CEO
Credential: BSW
Phone: 803-493-9389