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Organization
IMPACT SERVICES
Active
Organization
IMPACT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DENISE FOOTE (EXECUTIVE DIRECTOR)
(810) 985-5437
Entity
Organization
Contact information
Practice address
1001 MILITARY ST, PORT HURON, MI 48060-5416
(810) 985-5437
(810) 985-9011
Mailing address
1001 MILITARY ST, PORT HURON, MI 48060-5416
(810) 985-5437
(810) 985-9011
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
NULL
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
01/23/2007
Last updated
08/22/2020
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