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General NPI Number Information
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NPI Number | 1104645936
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Entity Type | Organization
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Legal Business Name | EMPOWERED ABILITIES HEALTHCARE SOLUTIONS, LLC
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 2606 11TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-4017
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Country | US
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Telephone | 941-264-9975
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Fax |
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Provider Business Mailing Address
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Address Line | 2606 11TH AVE W
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City | BRADENTON
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State | FL
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Zip | 34205-4017
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Country | US
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Telephone | 941-264-9975
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHNNIE LEE JOHNSON JR.
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Credential | LPN, CLC, SLC
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Telephone | 941-264-9975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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