Provider Demographics
NPI:1043926884
Name:EMPOWERED ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:EMPOWERED ASSISTED LIVING, LLC
Other - Org Name:EMPOWERED ASSISTED LIVING MANAGEMENT GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARLISIA
Authorized Official - Middle Name:
Authorized Official - Last Name:STANSBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-572-0770
Mailing Address - Street 1:760 STATE HIGHWAY 147
Mailing Address - Street 2:
Mailing Address - City:CENTER
Mailing Address - State:TX
Mailing Address - Zip Code:75935-6483
Mailing Address - Country:US
Mailing Address - Phone:936-572-0770
Mailing Address - Fax:
Practice Address - Street 1:719 US HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:TIMPSON
Practice Address - State:TX
Practice Address - Zip Code:75975-5108
Practice Address - Country:US
Practice Address - Phone:936-274-3050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty