Organization
IMPACT HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NKECHI H ADENIJI (OWNER)
(623) 205-8111
Entity
Organization
Contact information
Practice address
13615 W SAN JUAN AVE, LITCHFIELD PARK, AZ 85340-3313
(623) 205-8111
Mailing address
13615 W SAN JUAN AVE, LITCHFIELD PARK, AZ 85340-3313
(623) 205-8111
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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