Empowered Community Living LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EMPOWERED COMMUNITY LIVING LLC

Practice address

1501 Robert J Conlan Blvd NE Ste 110
Palm Bay, FL 32905-3560

Phone

(321) 499-3265

NPI assigned

Nov 5, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timika Marie WashingtonNPI 1295202190

Title

Owner

Phone

(321) 616-6181

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timika Marie Washington

  • Developmental Disabilities Clinic/Center
  • Palm Bay, FL
  • NPI 1295202190
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1326516709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 ROBERT J CONLAN BLVD NE STE 110",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053560",
            "telephone_number": "321-499-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 ROBERT J CONLAN BLVD NE STE 110",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329053560",
            "telephone_number": "321-499-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERED COMMUNITY LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-05",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "TIMIKA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-616-6181"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• In Home Supportive Care Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.