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General NPI Number Information
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NPI Number | 1801608039
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Entity Type | Organization
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Legal Business Name | EMPOWERMENT PATHWAYS LLC
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 145 ASCEND CIR APT 3102
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City | SAINT JOHNS
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State | FL
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Zip | 32259-4173
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Country | US
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Telephone | 904-990-4211
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Fax |
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Provider Business Mailing Address
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Address Line | 7643 GATE PKWY # 104-716
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City | JACKSONVILLE
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State | FL
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Zip | 32256-3092
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Country | US
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Telephone | 904-990-4211
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAMANTHA GRAHAM
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Credential |
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Telephone | 904-990-4211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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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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