Provider Demographics
NPI:1306435342
Name:EMPOWERMENTHEALTH.LLC
Entity type:Organization
Organization Name:EMPOWERMENTHEALTH.LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOISE
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:BELIZAIRE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:914-227-2048
Mailing Address - Street 1:11 PARK STREET
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3933
Mailing Address - Country:US
Mailing Address - Phone:845-826-4272
Mailing Address - Fax:
Practice Address - Street 1:11 PARK STREET
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-3933
Practice Address - Country:US
Practice Address - Phone:845-826-4272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)