Provider Demographics
NPI:1407186067
Name:THE EMPOWERMENT ACADEMY, LLC
Entity type:Organization
Organization Name:THE EMPOWERMENT ACADEMY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:MACHARIA
Authorized Official - Last Name:VENISEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-846-7524
Mailing Address - Street 1:3781 PRESIDENTIAL PKWY
Mailing Address - Street 2:SUITE 13
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-3702
Mailing Address - Country:US
Mailing Address - Phone:770-846-7524
Mailing Address - Fax:
Practice Address - Street 1:3781 PRESIDENTIAL PKWY
Practice Address - Street 2:SUITE 13
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-3702
Practice Address - Country:US
Practice Address - Phone:770-846-7524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care