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General NPI Number Information
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NPI Number | 1063991859
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Entity Type | Organization
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Legal Business Name | EMPOWERME REHABILITATION MO AGENCY
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Dates
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Enumeration Date | 08/13/2018
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 3751 WEST 10THSTREET
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City | SEDALIA
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State | MO
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Zip | 65301
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Country | US
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Telephone | 660-827-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 120 S CENTRAL AVE STE 1050
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City | CLAYTON
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State | MO
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Zip | 63105-1731
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Country | US
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Telephone | 314-485-7979
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JANAKA DIAS
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Credential |
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Telephone | 314-485-7979
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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