Impact Family Care Home Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

IMPACT FAMILY CARE HOME INC

Practice address

211 Red Holly Dr
Sanford, NC 27330-0389

Phone

(919) 708-5565

NPI assigned

Apr 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Syvilla R Pristell

Title

Administrator

Phone

(919) 708-5565

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407073125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 RED HOLLY DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273300389",
            "telephone_number": "919-708-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 RED HOLLY DR",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273300389",
            "telephone_number": "919-708-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT FAMILY CARE HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRISTELL",
        "authorized_official_first_name": "SYVILLA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-708-5565"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Sanford, NC
• Providers in Sanford, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.