Organization
IMPACT HEALTH CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP KIMELI LELEI (ADMINISTRATOR)
(763) 232-4989
Entity
Organization
Contact information
Practice address
6000 BASS LAKE RD, SUITE 113, CRYSTAL, MN 55429-2700
(763) 232-4989
(877) 896-4521
Mailing address
6000 BASS LAKE RD, SUITE 113, CRYSTAL, MN 55429-2700
(763) 232-4989
(877) 896-4521
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
338147
MN
Other
Enumeration date
03/13/2008
Last updated
03/13/2008
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