Provider Demographics
NPI:1013652361
Name:EMPOWERING TO ELEVATE INC
Entity Type:Organization
Organization Name:EMPOWERING TO ELEVATE INC
Other - Org Name:EMPOWERING TO ELEVATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-248-1264
Mailing Address - Street 1:31 S MAIN ST STE 240
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2070
Mailing Address - Country:US
Mailing Address - Phone:937-248-1264
Mailing Address - Fax:937-315-6121
Practice Address - Street 1:31 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2070
Practice Address - Country:US
Practice Address - Phone:937-248-1264
Practice Address - Fax:937-315-6121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health