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General NPI Number Information
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NPI Number | 1538066295
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Entity Type | Organization
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Legal Business Name | EMPOWERPATH BEHAVIORAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 10/24/2026
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Last Update Date | 10/24/2026
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Provider Practice Location Address
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Address Line | 277 COON RAPIDS BLVD NW # 400
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City | COON RAPIDS
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State | MN
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Zip | 55433-5843
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Country | US
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Telephone | 952-693-6873
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Fax |
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Provider Business Mailing Address
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Address Line | 7633 ALDRICH AVE N
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City | BROOKLYN PARK
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State | MN
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Zip | 55444-2544
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Country | US
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Telephone | 952-693-6873
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Fax |
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Authorized Official
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Title or Position | CASE MANAGER
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Name | ISAIAH PANTOE
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Credential | BSW, MSW
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Telephone | 952-693-6873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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