Provider Demographics
NPI:1124845870
Name:EMPOWERING STRONGER INDEPENDENCE
Entity type:Organization
Organization Name:EMPOWERING STRONGER INDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PETTUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-432-4417
Mailing Address - Street 1:1000 WHITE HORSE RD STE 806
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4414
Mailing Address - Country:US
Mailing Address - Phone:856-805-7163
Mailing Address - Fax:
Practice Address - Street 1:1000 WHITE HORSE RD STE 806
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4414
Practice Address - Country:US
Practice Address - Phone:856-805-7163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPOWERING STRONGER INDEPENDENCE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services