Impact Family Services LLC

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Legal business name

IMPACT FAMILY SERVICES LLC

Practice address

1504 N Randall Ave
Janesville, WI 53545-1150

Phone

(608) 751-9265

NPI assigned

Oct 19, 2023

Organization subpart

No

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

Authorized official

Name

Adrienne Cannella

Title

Partner

Phone

(815) 988-5701

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1609658160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 N RANDALL AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535451150",
            "telephone_number": "608-751-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 N RANDALL AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535451150",
            "telephone_number": "608-751-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT FAMILY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-19",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "CANNELLA",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "815-988-5701"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child Intellectual and/or Developmental Disabilities Respite Care in Janesville, WI
• Providers in Janesville, WI by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.