Provider Demographics
NPI:1578378410
Name:EMPOWERING CHANGES SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:EMPOWERING CHANGES SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-840-2611
Mailing Address - Street 1:507 N WASHINGTON ST STE 3
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32202-2734
Mailing Address - Country:US
Mailing Address - Phone:904-474-1500
Mailing Address - Fax:
Practice Address - Street 1:507 N WASHINGTON ST STE 3
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-2734
Practice Address - Country:US
Practice Address - Phone:904-474-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management