Organization
IMPACT V.I., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARIE MCMASTER (ADMINISTRATOR)
(954) 319-0148
Entity
Organization
Contact information
Practice address
11301 NW 19TH ST, PLANTATION, FL 33323-2109
(954) 319-0148
Mailing address
11301 NW 19TH ST, PLANTATION, FL 33323-2109
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/10/2015
Last updated
03/10/2015
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