Provider Demographics
NPI:1144710625
Name:EMPOWER DETOX AND RECOVERY CENTER
Entity type:Organization
Organization Name:EMPOWER DETOX AND RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:954-935-8400
Mailing Address - Street 1:2500 N POWERLINE RD STE 7
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-1049
Mailing Address - Country:US
Mailing Address - Phone:954-935-8400
Mailing Address - Fax:
Practice Address - Street 1:2500 N POWERLINE RD STE 7
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-1049
Practice Address - Country:US
Practice Address - Phone:954-935-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherPRIVATE INSURANCE