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General NPI Number Information
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NPI Number | 1629367065
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Entity Type | Organization
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Legal Business Name | EMPOWER INC
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Dates
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Enumeration Date | 04/06/2011
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 8924 SHEEP RANCH CT
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City | LAS VEGAS
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State | NV
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Zip | 89143-5419
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Country | US
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Telephone | 702-644-4195
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Fax | 702-644-2519
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Provider Business Mailing Address
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Address Line | 8924 SHEEP RANCH COURT
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City | LAS VEGAS
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State | NV
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Zip | 89143-5419
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Country | US
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Telephone | 702-644-4195
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Fax | 702-644-2519
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Authorized Official
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Title or Position | STAFF
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Name | MR. LORRETTO E OWEN
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Credential | MA
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Telephone | 702-838-3889
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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 | H1400104H113186
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License Number State | NV
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