Provider Demographics
NPI:1750733820
Name:EMPOWERING LIVES HOMECARE
Entity type:Organization
Organization Name:EMPOWERING LIVES HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONETTE
Authorized Official - Middle Name:PATRICE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:HOMEHEALTH
Authorized Official - Phone:407-738-7082
Mailing Address - Street 1:6441 CAMELLIA GARDEN DR
Mailing Address - Street 2:APT#101
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-6313
Mailing Address - Country:US
Mailing Address - Phone:407-801-1542
Mailing Address - Fax:407-704-1663
Practice Address - Street 1:6441 CAMELLIA GARDEN DR
Practice Address - Street 2:APT#101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-6313
Practice Address - Country:US
Practice Address - Phone:407-801-1542
Practice Address - Fax:407-704-1663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty