Organization
IMPACT COMMUNITY AND FAMILY SERVICES, INC
Active
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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