Provider Demographics
NPI:1760265383
Name:EMPOWER YOUR VISION
Entity Type:Organization
Organization Name:EMPOWER YOUR VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAREAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAINE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:314-323-1068
Mailing Address - Street 1:3910 S OLD HIGHWAY 94 STE 112
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-2834
Mailing Address - Country:US
Mailing Address - Phone:636-463-0330
Mailing Address - Fax:
Practice Address - Street 1:3910 S OLD HIGHWAY 94 STE 112
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-2834
Practice Address - Country:US
Practice Address - Phone:636-463-0330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)