# IMPACTFUL SENIOR HOME CARE LLC

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

## Provider details

- **NPI number:** 1275054173
- **Authorized official:** EDWINA VANOTOO (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (856) 885-6400

## Contact information

- **Practice address:** M3 REMBRANDT CT, PINE HILL, NJ 08021-6578
- **Practice address phone:** (856) 885-6400
- **Mailing address:** M3 REMBRANDT CT, PINE HILL, NJ 08021-6578
- **Mailing address phone:** (856) 885-6400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 0450152009 | NJ | Yes |

## Other

- **Enumeration date:** 06/29/2017
- **Last updated:** 07/21/2022