Organization
EMPOWERED COMMUNITY LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMIKA MARIE WASHINGTON (OWNER)
(321) 616-6181
Entity
Organization
Contact information
Practice address
1501 ROBERT J CONLAN BLVD NE STE 110, PALM BAY, FL 32905-3560
(321) 499-3265
Mailing address
1501 ROBERT J CONLAN BLVD NE STE 110, PALM BAY, FL 32905-3560
(321) 499-3265
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Enumeration date
11/05/2018
Last updated
09/16/2021
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