Provider Demographics
NPI:1487913885
Name:EMPOWERMENT HEALTHCARE, LLC
Entity type:Organization
Organization Name:EMPOWERMENT HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:LORENZEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:860-276-7443
Mailing Address - Street 1:8125 FRANCE AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-2714
Mailing Address - Country:US
Mailing Address - Phone:952-836-6862
Mailing Address - Fax:763-208-7071
Practice Address - Street 1:8125 FRANCE AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-2714
Practice Address - Country:US
Practice Address - Phone:952-836-6862
Practice Address - Fax:763-208-7071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24648310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN24648Medicaid