Impact Community Services LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

IMPACT COMMUNITY SERVICES LLC

Practice address

8204 Elmbrook Dr Ste 112
Dallas, TX 75247-4017

Phone

(702) 505-3213

NPI assigned

Sep 25, 2023

Organization subpart

No

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

Authorized official

Name

Devonte Christopher

Title

Owner

Phone

(702) 505-3213

Specialties & licenses 6

Addresses

Locations

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1649059031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8204 ELMBROOK DR STE 112",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8204 ELMBROOK DR STE 112",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474017",
            "telephone_number": "702-505-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-25",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "CHRISTOPHER",
        "authorized_official_first_name": "DEVONTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-505-3213"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Brett Immergluck, MD
• Janice M Imming-Rogers, MS,RN,APN
• Kimberly Imoh, MD
• Linda Ngozi Imoh, APRN, FNP-BC
• Flora Abiodun Imoudu
• Impact Minds
• Impact Minds
• Impairment & Disability Analysis, LP
• Impala Care Homes LLC
• Imperial Healthcare LLC

• Clinic/Center in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.