Provider Demographics
NPI:1245883859
Name:COMMUNITY AND FAMILY EMPOWERMENT
Entity type:Organization
Organization Name:COMMUNITY AND FAMILY EMPOWERMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:WERNER
Authorized Official - Last Name:BOSCO
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:502-554-8487
Mailing Address - Street 1:11106 DECIMAL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2440
Mailing Address - Country:US
Mailing Address - Phone:502-554-8487
Mailing Address - Fax:502-412-1405
Practice Address - Street 1:11106 DECIMAL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2440
Practice Address - Country:US
Practice Address - Phone:502-554-8487
Practice Address - Fax:502-412-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities