Impact Youth and Family Services, Inc.
Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Willow Spring, NC
NPI 1609926575 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1609926575
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
- License
- MHL-051-146 (NC)
- Legal business name
- IMPACT YOUTH AND FAMILY SERVICES, INC.
- Practice address
- 109 Deer Farm LN
Willow Spring, NC 27592-8505 - Phone
- (919) 639-3625
- Fax
- (888) 470-3543
- NPI assigned
- Jan 11, 2007
- Organization subpart
- No
Authorized official
- Name
- Larry Barther
- Title
- Ceo
- Phone
- (919) 639-3625
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | MHL-051-146 | NC | Yes |
Addresses
Primary practice location
109 Deer Farm LN
Willow Spring, NC 27592-8505
Mailing address
PO Box 157
Willow Spring, NC 27592-0157
Phone (919) 639-3625
Other providers in Willow Spring, NC
- Pamela Formyduval
- Tegran Osafu Fraites
- Cheryl Ann Henderson
- Thomas Bradley Hiatt
- House of Care, Inc
- Benjamin Ingraham
- Kisha Monique Lendore
- Lifegate Residential Care
- Lift Responders
- Jamie Macbride
All providers in Willow Spring, NC · Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.