Organization
PROFOUNDLY IMPACTING PEOPLE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY PIPKIN-WILDER (PRESIDENT)
(832) 724-1374
Entity
Organization
Contact information
Practice address
2622 CRYSTAL FALLS DR, PEARLAND, TX 77584-2508
(713) 436-7149
Mailing address
PO BOX 84136, PEARLAND, TX 77584-0018
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/02/2019
Last updated
01/06/2020
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