Organization
IMPACT INFUSIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHILOH FLYNN LPN (CEO)
(917) 436-8506
Entity
Organization
Contact information
Practice address
717 RIVER HOLLOW CT, CHESAPEAKE, VA 23320-7032
(917) 436-8506
Mailing address
717 RIVER HOLLOW CT, CHESAPEAKE, VA 23320-7032
(917) 436-8506
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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