Organization
IMPACT HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YVETTE JOHNSON TOWERS REGISTERED NURSE (DIRECTOR)
(414) 803-4585
Entity
Organization
Contact information
Practice address
8707 W NORTH AVE, WAUWATOSA, WI 53226-2723
(414) 803-4585
Mailing address
8707 W NORTH AVE, WAUWATOSA, WI 53226-2723
(414) 803-4585
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
101528-30
WI
251J00000X
Nursing Care Agency
101528-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073805255
—
WI
Enumeration date
01/02/2013
Last updated
01/02/2013
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