Organization
IMPACT HEALTH CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP LELEI (DIRECTOR)
(763) 533-3436
Entity
Organization
Contact information
Practice address
5901 BROOKLYN BLVD, SUITE 111, BROOKLYN CENTER, MN 55429-2517
(763) 533-4374
Mailing address
5901 BROOKLYN BLVD, SUITE 111, BROOKLYN CENTER, MN 55429-2517
(763) 533-4374
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
334266
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
334266
STATE CLASS A LICENSE
MN
Enumeration date
11/17/2006
Last updated
08/22/2020
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