| Impower, Inc | |
|
111 W Magnolia Ave Longwood FL 32750-4130 | |
| (407) 215-0095 | |
| Not Available |
| Full Name | Impower, Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 111 W Magnolia Ave, Longwood, Florida |
| Authorized Official Name and Position | Isabel Velasquez (CFO) |
| Authorized Official Contact | 4072150095 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impower, Inc 111 W Magnolia Ave Longwood FL 32750-4130 Ph: (407) 215-0095 | Impower, Inc 111 W Magnolia Ave Longwood FL 32750-4130 Ph: (407) 215-0095 |
| NPI Number | 1255005161 |
|---|---|
| Provider Enumeration Date | 08/04/2021 |
| Last Update Date | 08/04/2021 |
| Certification Date | 08/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255005161 | NPI | - | NPPES |
| 7590270-00 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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