Provider Demographics
NPI:1558735217
Name:EMPOWER FAMILIES FOUNDATION
Entity Type:Organization
Organization Name:EMPOWER FAMILIES FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEER RECOVERY SUPPORT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:TRACY
Authorized Official - Suffix:
Authorized Official - Credentials:PRSS
Authorized Official - Phone:405-919-8781
Mailing Address - Street 1:6909 E 99TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5938
Mailing Address - Country:US
Mailing Address - Phone:918-850-4784
Mailing Address - Fax:
Practice Address - Street 1:9726 E 42ND ST
Practice Address - Street 2:SUITE 124
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3652
Practice Address - Country:US
Practice Address - Phone:405-919-8781
Practice Address - Fax:918-728-8362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-18
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health