Provider Demographics
NPI:1740794098
Name:EMPOWERING LIVES
Entity Type:Organization
Organization Name:EMPOWERING LIVES
Other - Org Name:EMPOWERING LIVES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMURO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-344-1596
Mailing Address - Street 1:4702 ORKNEY DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2808
Mailing Address - Country:US
Mailing Address - Phone:386-344-1596
Mailing Address - Fax:
Practice Address - Street 1:4702 ORKNEY DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2808
Practice Address - Country:US
Practice Address - Phone:386-344-1596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARE 4 AMERICA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-11-24
Last Update Date:2017-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty