MEDICARE: EMPOWER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	H1400104H113186	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	H1400104H113186	OTHER	NV	BUSINESS LICENCE

General Provider Information

NPI Number	:	1629367065
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWER INC

Provider Business Mailing Address
First Line	:	8924 SHEEP RANCH COURT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143-5419
Country	:	US
Telephone Number	:	702-644-4195
Fax Number	:	702-644-2519

Provider Business Practice Location Address
First Line	:	8924 SHEEP RANCH CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89143-5419
Country	:	US
Telephone Number	:	702-644-4195
Fax Number	:	702-644-2519

Authorized Official
Title or Position	:	STAFF
Name	:	MR. LORRETTO E OWEN
Credential	:	MA
Telephone Number	:	702-838-3889

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	04/06/2011

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Directions to “EMPOWER INC ” Practice Location

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