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General NPI Number Information
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NPI Number | 1912723594
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Entity Type | Organization
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Legal Business Name | THE EMPOWERMENT PROGRAM
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 5424 E 62ND PL
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City | COMMERCE CITY
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State | CO
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Zip | 80022-3405
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Country | US
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Telephone | 720-769-2552
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 YORK ST
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City | DENVER
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State | CO
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Zip | 80206-1431
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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 | MEDICAID PROGRAM MANAGER
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Name | SOLEDAD HERRERA
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Credential |
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Telephone | 720-772-7397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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