NPIMap

Organization Active NPI

Impala Care Homes LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Dallas, TX
National Provider Identifier
1790359784
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
IMPALA CARE HOMES LLC
Practice address
444 W Commerce Street
Apt 3123
Dallas, TX 75208
Phone
(469) 910-4181
NPI assigned
May 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Authorized official

Name
David Mugomoke
Title
Owner
Phone
(469) 910-4181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

444 W Commerce Street
Apt 3123
Dallas, TX 75208

Mailing address

444 W Commerce Street
Apt 3123
Dallas, TX 75208
Phone (469) 910-4181

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620950400000",
    "number": "1790359784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 W COMMERCE STREET",
            "address_2": "APT 3123",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75208",
            "telephone_number": "469-910-4181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 W COMMERCE STREET",
            "address_2": "APT 3123",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75208",
            "telephone_number": "469-910-4181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPALA CARE HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "MUGOMOKE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-910-4181"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; 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.