NPIMap

Organization Active NPI

Impact Community and Family Services, Inc

  • Voluntary or Charitable Agency
  • Gastonia, NC
National Provider Identifier
1356649990
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
IMPACT COMMUNITY AND FAMILY SERVICES, INC
Practice address
312 Woodstream Dr
Gastonia, NC 28056-6923
Phone
(704) 460-3399
NPI assigned
Mar 7, 2011
Last updated
Mar 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Authorized official

Name
Mrs. Tammy Renee Harrell
Title
President, Ceo
Phone
(704) 460-3399

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Voluntary or Charitable Agency 251V00000X NU Primary
Early Intervention Provider Agency 252Y00000X NU
In Home Supportive Care Agency 253Z00000X NU
Community/Behavioral Health Agency 251S00000X NU
Supports Brokerage Agency 251X00000X NU

Addresses

Primary practice location

312 Woodstream Dr
Gastonia, NC 28056-6923

Mailing address

312 Woodstream Dr
Gastonia, NC 28056-6923
Phone (704) 460-3399

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299456000000",
    "number": "1356649990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 WOODSTREAM DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280566923",
            "telephone_number": "704-460-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 WOODSTREAM DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280566923",
            "telephone_number": "704-460-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT COMMUNITY AND FAMILY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-07",
        "last_updated": "2011-03-07",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT, CEO",
        "authorized_official_telephone_number": "704-460-3399",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.