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General NPI Number Information
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NPI Number | 1063194140
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Entity Type | Organization
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Legal Business Name | EMPOWER LIVING SERVICES LLC
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 1701 AMERICAN BLVD E STE 16
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1401
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Country | US
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Telephone | 612-756-9140
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 AMERICAN BLVD E STE 16
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1401
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | AISHA M ADAN
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Credential | RN
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Telephone | 612-756-9140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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