Provider Demographics
NPI:1174094106
Name:EMPOWERMENT FAMILY CARE INC
Entity type:Organization
Organization Name:EMPOWERMENT FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMNANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMBATOHANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-262-2506
Mailing Address - Street 1:8222 N 19TH AVE APT 207
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5224
Mailing Address - Country:US
Mailing Address - Phone:510-759-5633
Mailing Address - Fax:
Practice Address - Street 1:8161 W CATALINA DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-4712
Practice Address - Country:US
Practice Address - Phone:325-262-2506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty