Provider Demographics
NPI:1437384302
Name:EMPOWERMENT QUALITY CARE SERVICES, LLC
Entity Type:Organization
Organization Name:EMPOWERMENT QUALITY CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-717-7477
Mailing Address - Street 1:8535 CLIFF CAMERON DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5909
Mailing Address - Country:US
Mailing Address - Phone:704-717-7477
Mailing Address - Fax:704-717-7457
Practice Address - Street 1:8535 CLIFF CAMERON DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-5909
Practice Address - Country:US
Practice Address - Phone:704-717-7477
Practice Address - Fax:704-717-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8302830Medicaid