Provider Demographics
NPI:1649575325
Name:THE EMPOWERMENT PROGRAM
Entity type:Organization
Organization Name:THE EMPOWERMENT PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SOLEDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-772-7397
Mailing Address - Street 1:1600 YORK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1431
Mailing Address - Country:US
Mailing Address - Phone:303-320-1989
Mailing Address - Fax:303-320-3987
Practice Address - Street 1:5424 E 62ND PL
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-3405
Practice Address - Country:US
Practice Address - Phone:720-769-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO985069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty