Organization
FRESH IMPACT CHURCH, INC.
Active
Other names
Adult Activity Center
Organization subpart
No
Provider details
NPI number
Authorized official
TYRONE LANE (OWNER)
(678) 677-4041
Entity
Organization
Contact information
Practice address
11800 MAGNOLIA PKWY, MANVEL, TX 77578-1800
(678) 677-4041
Mailing address
3627 CIBOLO CT, PEARLAND, TX 77584-3975
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/21/2025
Last updated
05/21/2025
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