Organization
EMPOWERME REHABILITATION IL AGENCY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JANAKA DIAS (PRESIDENT)
(314) 485-7979
Entity
Organization
Contact information
Practice address
429 S MAIN ST, SHILOH, IL 62269-3080
(618) 622-9890
Mailing address
120 S CENTRAL AVE STE 1050, SAINT LOUIS, MO 63105-1731
(314) 485-7979
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/22/2018
Last updated
01/22/2018
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