Organization
EMPOWERING MINDS SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANEISHA FAGGART MEDICAL ASSISTANT (CEO/OWNER)
(980) 255-1733
Entity
Organization
Contact information
Practice address
150 BW THOMAS DR, FORT MILL, SC 29708-7230
(803) 548-1234
Mailing address
490 FISK ST NW, CONCORD, NC 28027-6604
(980) 255-1733
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/25/2017
Last updated
08/17/2017
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