NPIMap

Project Impact Inc.

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Lynwood, CA

NPI 1285330407 · NPPES record last updated May 2, 2023

Key facts

NPI
1285330407
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
PROJECT IMPACT INC.
Practice address
2640 Industry Way
Suites G and H
Lynwood, CA 90262-4000
Phone
(310) 631-9763
Fax
(310) 631-6680
NPI assigned
Jan 31, 2023
Organization subpart
No

Authorized official

Name
Dr. Matthew Ross Harris
Title
Executive Director
Phone
(310) 631-9763

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Project Impact Inc (2 organizations share this tax ID)

Locations

2640 Industry Way
Lynwood, CA 90262
Phone (310) 627-4525

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes

Addresses

Primary practice location

2640 Industry Way
Suites G and H
Lynwood, CA 90262-4000

Mailing address

2640 Industry Way
Suites G and H
Lynwood, CA 90262-4000
Phone (310) 631-9763

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 2, 2023.

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1285330407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "address_2": "SUITES G AND H",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624000",
            "telephone_number": "310-631-9763",
            "fax_number": "310-631-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "address_2": "SUITES G AND H",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624000",
            "telephone_number": "310-631-9763",
            "fax_number": "310-631-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT IMPACT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "310-631-9763",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

All providers in Lynwood, CA · Mental Health Clinic/Center (Including Community Mental Health Center) in California

Sources for this page

Verify at the official NPI Registry.