Organization Name: | THE EMPOWER HOUSE, LLC |
NPI Number: | 1710348362 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WENDY Y. SHEPHERD (ADMINISTRATOR) |
Mailing Address: | 18631 N. 19th Ave., Suite 158-305 Phoenix |
State: | AZ US |
Postal Code: | 85027 |
Phone Number: | 6239863987 |
Fax Number: | |
NPI Enumeration Date: | 03/10/2016 |
NPI Last Update Date: | 04/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320800000X |
License Number: | BH4796 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment Facility, Mental Illness |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |