Provider Demographics
NPI:1023695491
Name:EMPOWER U OUTPATIENT SERVICES
Entity type:Organization
Organization Name:EMPOWER U OUTPATIENT SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARLON
Authorized Official - Middle Name:W
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:908-907-7777
Mailing Address - Street 1:43 GRAND COVE WAY
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-7223
Mailing Address - Country:US
Mailing Address - Phone:908-907-7777
Mailing Address - Fax:855-500-3848
Practice Address - Street 1:1 BETHANY RD STE 92
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1669
Practice Address - Country:US
Practice Address - Phone:855-500-8348
Practice Address - Fax:855-500-3848
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPOWER U.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-24
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251E00000XAgenciesHome Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health