Impact Health Care Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

338147 Issued in MN

Legal business name

IMPACT HEALTH CARE SERVICES LLC

Practice address

6000 Bass Lake Rd
Suite 113
Crystal, MN 55429-2700

Phone

(763) 232-4989

Fax

(877) 896-4521

NPI assigned

Mar 13, 2008

Last updated

Mar 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Philip Kimeli Lelei

Title

Administrator

Phone

(763) 232-4989

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1649441049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 BASS LAKE RD",
            "address_2": "SUITE 113",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554292700",
            "telephone_number": "763-232-4989",
            "fax_number": "877-896-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 BASS LAKE RD",
            "address_2": "SUITE 113",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554292700",
            "telephone_number": "763-232-4989",
            "fax_number": "877-896-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT HEALTH CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "LELEI",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "KIMELI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "763-232-4989"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "338147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Crystal, MN
• Providers in Crystal, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.