Provider Demographics
NPI:1306713227
Name:HEALTH EMPOWERMENT THROUGH ACTIVE LEADERSHIP
Entity type:Organization
Organization Name:HEALTH EMPOWERMENT THROUGH ACTIVE LEADERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIAH
Authorized Official - Middle Name:Y
Authorized Official - Last Name:GRAJEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-805-9856
Mailing Address - Street 1:1013 SUNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-5357
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5250 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407-7051
Practice Address - Country:US
Practice Address - Phone:909-310-2013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty