Provider Demographics
NPI:1639866908
Name:EMPOWERMENT MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:EMPOWERMENT MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:907-720-7103
Mailing Address - Street 1:2440 E TUDOR RD # 1099
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1185
Mailing Address - Country:US
Mailing Address - Phone:907-231-2333
Mailing Address - Fax:907-222-6153
Practice Address - Street 1:4141 B ST STE 207
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5940
Practice Address - Country:US
Practice Address - Phone:907-231-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)