| Empowered For Excellence, Empowering Youth, Llc | |
|
3170 W Central Ave Ste G Toledo OH 43606-2945 | |
| (310) 981-3332 | |
| Not Available |
| Full Name | Empowered For Excellence, Empowering Youth, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3170 W Central Ave Ste G, Toledo, Ohio |
| Authorized Official Name and Position | Jonathan James (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3109813332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Empowered For Excellence, Empowering Youth, Llc 3170 W Central Ave Ste G Toledo OH 43606-2945 Ph: (419) 770-0295 | Empowered For Excellence, Empowering Youth, Llc 3170 W Central Ave Ste G Toledo OH 43606-2945 Ph: (310) 981-3332 |
| NPI Number | 1700457181 |
|---|---|
| Provider Enumeration Date | 07/07/2021 |
| Last Update Date | 07/07/2021 |
| Certification Date | 07/07/2021 |
| Medicare PECOS PAC ID | 9739602905 |
|---|---|
| Medicare Enrollment ID | O20250327003679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700457181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Sara H Bojorquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790077451 PECOS PAC ID: 8426571696 Enrollment ID: I20250327003820 |
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