Organization
EMPOWERING LIVES CREATING POSSIBILITIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TYEISHA C JONES M.ED. (PRESIDENT, CEO)
(443) 876-4091
Entity
Organization
Contact information
Practice address
3172 EBBTIDE DR, EDGEWOOD, MD 21040-2921
(443) 876-4091
Mailing address
3172 EBBTIDE DR, EDGEWOOD, MD 21040-2921
(443) 876-4091
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MD
Other
Enumeration date
11/16/2009
Last updated
11/16/2009
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