=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053006577
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | POWER FOR LIVING ENTERPRISES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2023
-----------------------------------------------------
Last Update Date | 08/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 106 SHOPPERS WAY STE 105
-----------------------------------------------------
City | BRUNSWICK
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31525-0522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-421-1001
-----------------------------------------------------
Fax | 912-421-1001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2607
-----------------------------------------------------
City | BRUNSWICK
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31521-2607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-421-1001
-----------------------------------------------------
Fax | 912-689-1054
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/OWNER
-----------------------------------------------------
Name | JANEL HOLLAND
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 912-421-1001
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------