Organization
FAMILY IMPACT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERRICKA STARK MSW, CAPSW (CO-OWNER/DIRECTOR)
(262) 635-5135
Entity
Organization
Contact information
Practice address
829 S GREEN BAY RD, STE 109, MOUNT PLEASANT, WI 53406-4058
(262) 880-5864
(262) 995-0655
Mailing address
6601 WASHINGTON AVE, RACINE, WI 53406-4058
(262) 635-5135
(262) 995-7333
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4425-125
WI
Other
Enumeration date
10/04/2011
Last updated
02/24/2015
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