Provider Demographics
NPI:1699497917
Name:EMPOWER FAMILY THERAPIES
Entity type:Organization
Organization Name:EMPOWER FAMILY THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-439-4148
Mailing Address - Street 1:3240 ROCKING RM LN
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-2823
Mailing Address - Country:US
Mailing Address - Phone:909-706-9918
Mailing Address - Fax:800-754-1646
Practice Address - Street 1:3240 ROCKING RM LN
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-2823
Practice Address - Country:US
Practice Address - Phone:909-706-9918
Practice Address - Fax:800-754-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty