Impact Infusions, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

IMPACT INFUSIONS, LLC

Practice address

717 River Hollow CT
Chesapeake, VA 23320-7032

Phone

(917) 436-8506

NPI assigned

May 17, 2023

Organization subpart

No

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

Authorized official

Name

Shiloh Flynn, LPN

Title

Ceo

Phone

(917) 436-8506

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1684281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1477244820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 RIVER HOLLOW CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233207032",
            "telephone_number": "917-436-8506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 RIVER HOLLOW CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233207032",
            "telephone_number": "917-436-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT INFUSIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-17",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "FLYNN",
        "authorized_official_first_name": "SHILOH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-436-8506",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.