Organization
LIFE EMPOWERED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAYLOR LOGAN (CEO)
(231) 408-7814
Entity
Organization
Contact information
Practice address
18135 SHAMROCK BLVD, BIG RAPIDS, MI 49307-9726
(231) 408-7814
Mailing address
18135 SHAMROCK BLVD, BIG RAPIDS, MI 49307-9726
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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