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General NPI Number Information
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NPI Number | 1013543867
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Entity Type | Organization
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Legal Business Name | EMPOWER INCLUSION LLC
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Dates
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Enumeration Date | 03/12/2020
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 1098 PRAIRIE VIEW LN
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City | WACONIA
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State | MN
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Zip | 55387-4001
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Country | US
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Telephone | 952-373-1053
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 181
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City | EXCELSIOR
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State | MN
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Zip | 55331-0181
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Country | US
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Telephone | 952-373-1053
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Fax |
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Authorized Official
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Title or Position | DIR. INCLUSIVE EMPLOYMENT/OWNER
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Name | ALEXANDRA RAE OLADOYIN
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Credential |
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Telephone | 952-373-1053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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