Healthcare Provider Details

I. General information

NPI: 1467131441
Provider Name (Legal Business Name): EMPOWER RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 PRICE PL STE 208
MADISON WI
53705-3262
US

IV. Provider business mailing address

313 PRICE PL STE 208
MADISON WI
53705-3262
US

V. Phone/Fax

Practice location:
  • Phone: 608-571-3866
  • Fax:
Mailing address:
  • Phone: 608-571-3866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: AARON HOFFNUNG
Title or Position: OWNER
Credential: MD
Phone: 608-571-3866