Provider Demographics
NPI:1992889562
Name:EMPOWERMENT RESOURCE ASSOCIATES, INC.
Entity type:Organization
Organization Name:EMPOWERMENT RESOURCE ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECTIVE DIRECTOR AND PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, MS
Authorized Official - Phone:215-564-0680
Mailing Address - Street 1:1733 SPRING GARDEN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3915
Mailing Address - Country:US
Mailing Address - Phone:215-564-0680
Mailing Address - Fax:215-564-0680
Practice Address - Street 1:1733 SPRING GARDEN ST FL 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3915
Practice Address - Country:US
Practice Address - Phone:215-564-0680
Practice Address - Fax:215-564-0680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA132910261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01791830OtherDEPT. OF PUBLIC WELFARE