Provider Demographics
NPI:1902460264
Name:ADAPTIVE EMPOWERMENT LLC
Entity Type:Organization
Organization Name:ADAPTIVE EMPOWERMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MADDUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-454-0541
Mailing Address - Street 1:1641 CLIFTON TER NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-1711
Mailing Address - Country:US
Mailing Address - Phone:540-454-0541
Mailing Address - Fax:
Practice Address - Street 1:1641 CLIFTON TER NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-1711
Practice Address - Country:US
Practice Address - Phone:540-454-0541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care