Organization
IMPACT COMMUNITY AND FAMILY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY RENEE HARRELL (PRESIDENT, CEO)
(704) 460-3399
Entity
Organization
Contact information
Practice address
312 WOODSTREAM DR, GASTONIA, NC 28056-6923
(704) 460-3399
Mailing address
312 WOODSTREAM DR, GASTONIA, NC 28056-6923
(704) 460-3399
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
03/07/2011
Last updated
03/07/2011
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