Impact Home LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

Legal business name

IMPACT HOME LLC

Practice address

13615 W San Juan Ave
Litchfield Park, AZ 85340-3313

Phone

(623) 205-8111

NPI assigned

Dec 8, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Nkechi H Adeniji

Title

Owner

Phone

(623) 205-8111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1194436337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13615 W SAN JUAN AVE",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403313",
            "telephone_number": "623-205-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13615 W SAN JUAN AVE",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403313",
            "telephone_number": "623-205-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-08",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "ADENIJI",
        "authorized_official_first_name": "NKECHI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-205-8111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Respite Care in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Respite Care in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.