Organization
LASTING IMPRESSIONS LLC
Active
Organization
LASTING IMPRESSIONS LLC
Active
Other names
Lasting Impressions Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE PEGUESE CRUMPTON QP (OWNER)
(336) 848-9222
Entity
Organization
Contact information
Practice address
907 BLAZINGWOOD DR, GREENSBORO, NC 27406-8265
(336) 848-9222
(336) 848-9222
Mailing address
907 BLAZINGWOOD DR, GREENSBORO, NC 27406-8265
(336) 848-9222
(336) 848-9222
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
05/20/2026
Last updated
05/20/2026
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