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General NPI Number Information
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NPI Number | 1003456377
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Entity Type | Organization
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Legal Business Name | AGENCY FOR EMPOWERMENT & SUPPORT, LLC
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 507 LANCER OAK DR
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City | APOPKA
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State | FL
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Zip | 32712-2762
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Country | US
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Telephone | 407-814-8767
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Fax | 407-814-8767
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Provider Business Mailing Address
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Address Line | 581 N PARK AVE UNIT 2791
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City | APOPKA
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State | FL
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Zip | 32704-8720
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Country | US
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Telephone | 240-277-8688
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Fax | 407-814-8767
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Authorized Official
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Title or Position | FOUNDER CEO
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Name | STEPHANIE GEORGE
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Credential | BACHELOR'S DEGREE
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Telephone | 240-277-8688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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