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General NPI Number Information
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NPI Number | 1255012159
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Entity Type | Organization
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Legal Business Name | EMPOWER AND THRIVE BEHAVIORAL SERVICES, LLC
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Dates
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Enumeration Date | 07/25/2023
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 181 N GRANT ST STE 204
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City | CANBY
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State | OR
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Zip | 97013-3600
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Country | US
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Telephone | 971-917-7881
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Fax | 503-506-0499
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Provider Business Mailing Address
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Address Line | PO BOX 451
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City | CANBY
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State | OR
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Zip | 97013-0451
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Country | US
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Telephone | 971-917-7881
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Fax | 503-506-0499
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Authorized Official
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Title or Position | CEO, DIRECTOR
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Name | ERIN KATHLEEN REED
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Credential | BCBA, LBA
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Telephone | 971-917-7881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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