Provider Demographics
NPI:1174887780
Name:EMPOWERING BATON ROUGE, L.L.C.
Entity type:Organization
Organization Name:EMPOWERING BATON ROUGE, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:225-266-5813
Mailing Address - Street 1:204 BEVERLY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-5031
Mailing Address - Country:US
Mailing Address - Phone:225-266-5813
Mailing Address - Fax:
Practice Address - Street 1:8676 GOODWOOD BLVD STE 402
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7914
Practice Address - Country:US
Practice Address - Phone:225-266-5813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA93401041C0700X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty