Provider Demographics
NPI:1730992967
Name:EMPOWERMENT CENTER OF SOUTHERN NEVADA LLC
Entity type:Organization
Organization Name:EMPOWERMENT CENTER OF SOUTHERN NEVADA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-721-8505
Mailing Address - Street 1:1024 W OWENS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-2520
Mailing Address - Country:US
Mailing Address - Phone:702-636-8729
Mailing Address - Fax:702-441-1808
Practice Address - Street 1:1024 W OWENS AVE STE B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-2520
Practice Address - Country:US
Practice Address - Phone:702-636-8729
Practice Address - Fax:702-441-1808
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPOWERMENT CENTER OF SOUTHERN NEVADA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty