# IMPACT COMMUNTIY SERVICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184922916
- **Authorized official:** MR. DONALD WADE SKIPPER (BASIC SKILLS TRAINER)
- **Authorized official phone:** (775) 378-6722

## Contact information

- **Practice address:** 9801 CRYSTALLINE DR, RENO, NV 89506-7566
- **Practice address phone:** (775) 677-2640
- **Mailing address:** 9801 CRYSTALLINE DR, RENO, NV 89506-7566
- **Mailing address phone:** (775) 677-2640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | GF125403151 | NV | Yes |

## Other

- **Enumeration date:** 03/02/2011
- **Last updated:** 03/02/2011