Provider Demographics
NPI:1215618277
Name:EMPOWERED HEALTH ADULT DAY SERVICES
Entity type:Organization
Organization Name:EMPOWERED HEALTH ADULT DAY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMIKA
Authorized Official - Middle Name:M
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-778-0815
Mailing Address - Street 1:5817 BEECHCROFT RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-3877
Mailing Address - Country:US
Mailing Address - Phone:614-291-8592
Mailing Address - Fax:
Practice Address - Street 1:5797 BEECHCROFT RD STE F
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2758
Practice Address - Country:US
Practice Address - Phone:614-291-8592
Practice Address - Fax:614-392-0051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251E00000XAgenciesHome Health