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General NPI Number Information
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NPI Number | 1225814502
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Entity Type | Organization
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Legal Business Name | EMPOWER BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 09/04/2023
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Last Update Date | 09/04/2023
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Provider Practice Location Address
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Address Line | 6200 SARATOGA BLVD UNIT 2
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City | CORPUS CHRISTI
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State | TX
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Zip | 78414-3478
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Country | US
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Telephone | 361-717-1608
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Fax |
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Provider Business Mailing Address
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Address Line | 9314 RYDER DR
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City | SAN ANTONIO
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State | TX
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Zip | 78254-2000
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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 | RBT
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Name | MAKAYLA MAXINE IBARRA
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Credential |
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Telephone | 361-288-9575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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