Provider Demographics
NPI:1811404015
Name:EMPOWERMENT BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:EMPOWERMENT BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, PSYCHIATRIC SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:OMORUYI
Authorized Official - Middle Name:EPHRAIM
Authorized Official - Last Name:OKUNDAYE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-254-0265
Mailing Address - Street 1:PO BOX 871
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21203-0871
Mailing Address - Country:US
Mailing Address - Phone:443-682-5807
Mailing Address - Fax:
Practice Address - Street 1:106 OLD COURT RD STE 303
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4076
Practice Address - Country:US
Practice Address - Phone:410-254-0265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health