NPIMap

Organization Active NPI

Impactful Human Services LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Berwyn, PA
National Provider Identifier
1568072759
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
IMPACTFUL HUMAN SERVICES LLC
Practice address
1055 Westlakes Dr Ste 300
Berwyn, PA 19312-2410
Phone
(877) 500-4742
Fax
(877) 500-4742
NPI assigned
Aug 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Authorized official

Name
Edwina Vanotoo
Title
Office Manager
Phone
(877) 500-4742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

1055 Westlakes Dr Ste 300
Berwyn, PA 19312-2410

Mailing address

1055 Westlakes Dr Ste 300
Berwyn, PA 19312-2410
Phone (877) 500-4742

National Provider Directory

National Provider Directory
Tax ID family
Impactful Human Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596412800000",
    "number": "1568072759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 WESTLAKES DR STE 300",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193122410",
            "telephone_number": "877-500-4742",
            "fax_number": "877-500-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 WESTLAKES DR STE 300",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193122410",
            "telephone_number": "877-500-4742",
            "fax_number": "877-500-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACTFUL HUMAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A",
        "authorized_official_last_name": "VANOTOO",
        "authorized_official_first_name": "EDWINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "877-500-4742"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.