Organization
JABEZ EMPOWERMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL CLARDY STEVENS (PRESIDENT)
(931) 906-3993
Entity
Organization
Contact information
Practice address
175 STATELINE ROAD, SUITE 4, OAK GROVE, KY 42262
(931) 906-3993
(931) 503-0472
Mailing address
375 DOVER RD STE B, CLARKSVILLE, TN 37042-4144
(931) 906-3993
(931) 503-0472
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
KY
251S00000X
Community/Behavioral Health Agency
Primary
—
KY
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053602367
—
KY
05
—
65
—
TN
Enumeration date
04/21/2011
Last updated
05/27/2011
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