Provider Demographics
NPI:1104645936
Name:EMPOWERED ABILITIES HEALTHCARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:EMPOWERED ABILITIES HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPN, CLC, SLC
Authorized Official - Phone:941-264-9975
Mailing Address - Street 1:2606 11TH AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-4017
Mailing Address - Country:US
Mailing Address - Phone:941-264-9975
Mailing Address - Fax:
Practice Address - Street 1:2606 11TH AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-4017
Practice Address - Country:US
Practice Address - Phone:941-264-9975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health