Provider Demographics
NPI:1639687056
Name:EMPOWER HOME CARE, LLC.
Entity Type:Organization
Organization Name:EMPOWER HOME CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THURMAN
Authorized Official - Middle Name:DIXON
Authorized Official - Last Name:GENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-562-8877
Mailing Address - Street 1:11225 N 28TH DRIVE
Mailing Address - Street 2:SUITE D115E
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029
Mailing Address - Country:US
Mailing Address - Phone:480-562-8877
Mailing Address - Fax:866-576-9928
Practice Address - Street 1:11225 N 28TH DRIVE
Practice Address - Street 2:SUITE D115E
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029
Practice Address - Country:US
Practice Address - Phone:480-562-8877
Practice Address - Fax:866-576-9928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-19
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZL22270950251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZL22270950Medicaid