Organization
IMPACT LIFE HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUFUNMI LOLA JOHNSON (DIRECTOR)
(240) 467-1127
Entity
Organization
Contact information
Practice address
7607 BARKBRIDGE RD, CHESTERFIELD, VA 23832-8288
(804) 833-6052
Mailing address
10482 BALTIMORE AVE PMB 377, BELTSVILLE, MD 20705
(240) 467-1127
(132) 397-8144
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
06/03/2024
Last updated
03/17/2025
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