Impact Community Health

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

IMPACT COMMUNITY HEALTH

Practice address

16200 Rosemont Ave
Detroit, MI 48219-4168

Phone

(734) 642-5498

Fax

(313) 731-0613

NPI assigned

Oct 24, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Latrice McClendon

Title

Mihp Coordinator

Phone

(734) 642-5498

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1114478229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23734",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482230734",
            "telephone_number": "734-642-5498",
            "fax_number": "313-731-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16200 ROSEMONT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482194168",
            "telephone_number": "734-642-5498",
            "fax_number": "313-731-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "MCCLENDON",
        "authorized_official_first_name": "LATRICE",
        "authorized_official_title_or_position": "MIHP COORDINATOR",
        "authorized_official_telephone_number": "734-642-5498",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imani House Ministry Outreach Church
• Susan Imbier, RN MSN NE-BC
• Imhotep Medical Services, Inc.
• Immaculate Activities Corporation
• Impact Care, LLC
• Impact Community Services
• Impact Life Solutions, LLC
• Jenny Impemba, DO
• Imperative Home Care LLC
• Imperial Jewelry by Ellice, Inc

• Case Management Agency in Detroit, MI
• Providers in Detroit, MI by specialty
• Case Management Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.