Provider Demographics
NPI: | 1619864584 |
---|---|
Name: | EMPOWERIZE THERAPY CENTER LLC |
Entity type: | Organization |
Organization Name: | EMPOWERIZE THERAPY CENTER LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER, PHYSICAL THERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ALICIA |
Authorized Official - Middle Name: | KAY |
Authorized Official - Last Name: | HISEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DPT |
Authorized Official - Phone: | 810-772-7600 |
Mailing Address - Street 1: | 625 KENMOOR AVE SE STE 350 |
Mailing Address - Street 2: | PMB 881535 |
Mailing Address - City: | GRAND RAPIDS |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 49546-2395 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 9715 VILLAGE PLACE BLVD |
Practice Address - Street 2: | |
Practice Address - City: | BRIGHTON |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48116-2087 |
Practice Address - Country: | US |
Practice Address - Phone: | 810-772-7600 |
Practice Address - Fax: | 810-772-7630 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-06-23 |
Last Update Date: | 2025-06-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology | Group - Multi-Specialty |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |