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Organization
IMPACT LIVES CONSULTING GROUP LLC
Active
Organization
IMPACT LIVES CONSULTING GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOLIE WOODSTOCK (DIRECTOR OF ACCOUNTING & H/R)
(800) 460-2152
Entity
Organization
Contact information
Practice address
11613 SW 216TH ST, MIAMI, FL 33170-2933
(800) 460-2152
(800) 460-2152
Mailing address
11613 SW 216TH ST, MIAMI, FL 33170-2933
(800) 460-2152
(800) 460-2152
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/24/2019
Last updated
05/24/2019
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