Organization
EMPOWERMENT ARIZONA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY EVANS (MANAGER)
(602) 524-5521
Entity
Organization
Contact information
Practice address
5501 N 19TH AVE STE 430, PHOENIX, AZ 85015-2481
(602) 524-5521
Mailing address
5501 N 19TH AVE STE 430, PHOENIX, AZ 85015-2481
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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