Provider Demographics
NPI:1285347179
Name:EMPOWERED HEALTH CARE SERVICES
Entity type:Organization
Organization Name:EMPOWERED HEALTH CARE SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALESSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RITACCO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:774-823-0028
Mailing Address - Street 1:22 WEST ST STE 4
Mailing Address - Street 2:
Mailing Address - City:MILLBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01527-2677
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22 WEST ST STE 4
Practice Address - Street 2:
Practice Address - City:MILLBURY
Practice Address - State:MA
Practice Address - Zip Code:01527-2677
Practice Address - Country:US
Practice Address - Phone:508-581-4215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1316432917Medicaid