Provider Demographics
NPI:1174277875
Name:EMPOWERED TO STAND HEALTH SERVICES
Entity Type:Organization
Organization Name:EMPOWERED TO STAND HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMUNITY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIGANA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-733-3911
Mailing Address - Street 1:8110 HARFORD RD APT B
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5786
Mailing Address - Country:US
Mailing Address - Phone:443-733-3911
Mailing Address - Fax:
Practice Address - Street 1:8110 HARFORD RD APT B
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-5786
Practice Address - Country:US
Practice Address - Phone:443-733-3911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health