Provider Demographics
NPI:1386238723
Name:EMPOWER WELLNESS, LLC
Entity type:Organization
Organization Name:EMPOWER WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:912-584-3263
Mailing Address - Street 1:1610 ALICE ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-4533
Mailing Address - Country:US
Mailing Address - Phone:912-584-3263
Mailing Address - Fax:912-809-2296
Practice Address - Street 1:1610 ALICE ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-4533
Practice Address - Country:US
Practice Address - Phone:912-584-3263
Practice Address - Fax:912-809-2296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2025-04-22
Deactivation Date:2025-04-04
Deactivation Code:
Reactivation Date:2025-04-21
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)