Provider Demographics
NPI:1770354243
Name:EMPOWERED MINDS BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:EMPOWERED MINDS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSHAUNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-360-9778
Mailing Address - Street 1:4860 COX RD # 262
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9275
Mailing Address - Country:US
Mailing Address - Phone:804-258-6020
Mailing Address - Fax:
Practice Address - Street 1:4860 COX RD # 262
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-9275
Practice Address - Country:US
Practice Address - Phone:804-258-6020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health