Provider Demographics
NPI:1255116208
Name:EMPOWER ABA, LLC
Entity type:Organization
Organization Name:EMPOWER ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FLASCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-457-7156
Mailing Address - Street 1:206 KUPUNA ST
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7904
Mailing Address - Country:US
Mailing Address - Phone:609-457-7156
Mailing Address - Fax:
Practice Address - Street 1:206 KUPUNA ST
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7904
Practice Address - Country:US
Practice Address - Phone:609-457-7156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health