Organization
EMPOWERED LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FASHENDA LITTLE-GERALD (PRESIDENT)
(704) 577-2139
Entity
Organization
Contact information
Practice address
103 WILKES DR STE E, MONROE, NC 28110-2798
(704) 577-2139
Mailing address
11012 PERSIMMON CREEK DR, MINT HILL, NC 28227-6687
(704) 577-2139
(844) 272-1223
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
347E00000X
Transportation Broker
—
—
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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