CMS-1500 Box 24J / 33a • NPI
1548979818
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
3104A0625X
Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness
Box 32 Service Location & ZIP+4
719 US HIGHWAY 59 N, TIMPSON, TX, 75975-5108
✓ 9-Digit EDI 837 ZIP+4 (75975-5108)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1548979818 (EMPOWERED ASSISTED LIVING, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1548979818 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | EMPOWERED ASSISTED LIVING, LLC |
| Plain-English Specialty | Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness NUCC Code: 3104A0625X (Assisted Living Facility, Assisted Living, Mental Illness) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 719 US HIGHWAY 59 N, TIMPSON, TX, 75975-5108 |
| Practice Telephone / Fax | Tel: (936) 572-0770 |
| Administrative Mailing Address | 719 US HIGHWAY 59 N, TIMPSON, TX, 75975-5108 |
| Enumeration & Last Sync | Enumerated: 2022-11-16 | CMS Record Updated: 2026-07-29 |
| Authorized Official | ARLISIA STANSBERRY (CEO) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (3104A0625X)
What Does Taxonomy Code 3104A0625X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3104A0625X translates to:
"Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (EMPOWERED ASSISTED LIVING, LLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
251S00000X — Community/Behavioral HealthPlain English: Licensed & Credentialed Community/Behavioral Health | State: N/A | License: Verified | Primary: Secondary |
310400000X — Assisted Living FacilityPlain English: Licensed & Credentialed Assisted Living Facility | State: N/A | License: Verified | Primary: Secondary |
3104A0625X — Assisted Living Facility, Assisted Living, Mental IllnessPlain English: Licensed & Credentialed Assisted Living Facility, Assisted Living, Mental Illness | State: N/A | License: Verified | Primary: Yes (Primary) |
343800000X — Secured Medical Transport (VAN)Plain English: Licensed & Credentialed Secured Medical Transport (VAN) | State: N/A | License: Verified | Primary: Secondary |
347C00000X — Private VehiclePlain English: Licensed & Credentialed Private Vehicle | State: N/A | License: Verified | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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