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Organization

EMPOWER SPORTS NETWORK. INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL PAUL KININGHAM (FOUNDER & EXECUTIVE DIRECTOR)
(908) 902-1824
Entity
Organization

Contact information

Practice address
713 GREENS AVE APT 4, LONG BRANCH, NJ 07740-4924
(908) 902-1824
Mailing address
PO BOX 4, OCEANPORT, NJ 07757-0004
(908) 902-1824

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
05/02/2025
Last updated
05/02/2025
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