Organization
EMPOWER U LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA LOUISE WAGNER (CEO)
(319) 481-9203
Entity
Organization
Contact information
Practice address
117 DAKOTA CT, ANAMOSA, IA 52205-1194
(319) 481-9203
Mailing address
117 DAKOTA CT, ANAMOSA, IA 52205-1194
(319) 481-9203
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
03/15/2024
Last updated
03/15/2024
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