Impact Youth Services, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

88314001 Issued in VA

Legal business name

IMPACT YOUTH SERVICES, LLC

Practice address

6725 Casey Savannah LN
Richmond, VA 23234-8013

Phone

(804) 301-9624

Fax

(804) 454-0243

NPI assigned

May 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Debbie Loureen Cadet, PH. D

Title

Chief Administrative Officer

Phone

(804) 301-9624

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1285801928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14507 GLENMORGAN DR",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238316638",
            "telephone_number": "804-301-9624",
            "fax_number": "804-454-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6725 CASEY SAVANNAH LN",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232348013",
            "telephone_number": "804-301-9624",
            "fax_number": "804-454-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT YOUTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "CADET",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "LOUREEN",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "804-301-9624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH. D"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": "88314001",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "88314001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terence Alfred Imbery, D.D.S
• Hal Irwin Imburg, LPC
• Immediate MD, PLLC
• Impact Life Residential Care
• Impact on Youth Services, LLC
• Improve ABA of VA LLC
• Impulse Transport LLC
• In Good Hands Residential LLC
• In Home Solutions LLC
• In Safe Arms Transportation Service

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Richmond, VA
• Providers in Richmond, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.