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General NPI Number Information
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NPI Number | 1639356199
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Entity Type | Organization
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Legal Business Name | EMPOWERED TO SUCCEED, INC.
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 01/12/2009
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Provider Practice Location Address
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Address Line | 352 W HARDEN ST SUITE C
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City | BURLINGTON
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State | NC
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Zip | 27215-7516
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Country | US
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Telephone | 980-253-4434
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Fax |
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Provider Business Mailing Address
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Address Line | 352 W HARDEN ST SUITE C
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City | BURLINGTON
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State | NC
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Zip | 27215-7516
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Country | US
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Telephone | 980-253-4434
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. DETTA CULP
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Credential |
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Telephone | 980-253-4434
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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 | NC
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