Organization Active NPI

Impact Life Home Health, LLC - Healthcare Series

  • Home Health Agency
  • Los Fresnos, TX
National Provider Identifier
1760246169
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
IMPACT LIFE HOME HEALTH, LLC - HEALTHCARE SERIES
Practice address
9475 Los Olmos Dr
Los Fresnos, TX 78566
Phone
(956) 371-7476
Fax
(956) 594-6261
NPI assigned
Feb 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Authorized official

Name
Jesus Rodolfo FloresNPI 1861621047
Title
Managing Member
Phone
(956) 455-5587

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

9475 Los Olmos Dr
Los Fresnos, TX 78566

Mailing address

9475 Los Olmos Dr
Los Fresnos, TX 78566
Phone (956) 371-7476

Other names 1

  • Impact Life Healthcare Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718755200000",
    "number": "1760246169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9475 LOS OLMOS DR",
            "city": "LOS FRESNOS",
            "state": "TX",
            "postal_code": "78566",
            "telephone_number": "956-371-7476",
            "fax_number": "956-594-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9475 LOS OLMOS DR",
            "city": "LOS FRESNOS",
            "state": "TX",
            "postal_code": "78566",
            "telephone_number": "956-371-7476",
            "fax_number": "956-594-6261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT LIFE HOME HEALTH, LLC - HEALTHCARE SERIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "JESUS",
        "authorized_official_middle_name": "RODOLFO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "956-455-5587"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impact Life Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Impact Life Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Fresnos, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.