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General NPI Number Information
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NPI Number | 1568618957
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Entity Type | Organization
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Legal Business Name | EMPOWERMENT GROUP HOME CARE INC.
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 5522 WOODBERRY RD
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City | DURHAM
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State | NC
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Zip | 27707-5359
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Country | US
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Telephone | 919-403-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 1905 LANDON FARMS LN
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City | DURHAM
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State | NC
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Zip | 27704-4792
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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 | PRESIDENT
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Name | MS. TAMMIE HOLLINGSWORTH
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Credential |
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Telephone | 919-403-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | MHL032326
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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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 | 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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