Organization
IMPACT FAMILY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIENNE CANNELLA (PARTNER)
(815) 988-5701
Entity
Organization
Contact information
Practice address
1504 N RANDALL AVE, JANESVILLE, WI 53545-1150
(608) 751-9265
Mailing address
1504 N RANDALL AVE, JANESVILLE, WI 53545-1150
(608) 751-9265
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
10/19/2023
Last updated
09/17/2024
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