NPIMap

Organization Active NPI

Project Impact Inc.

  • Community/Behavioral Health Agency
  • Lynwood, CA
National Provider Identifier
1801092952
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
MFC 18585 Issued in CA
Legal business name
PROJECT IMPACT INC.
Practice address
2640 Industry Way
Suites G and H
Lynwood, CA 90262-4000
Phone
(310) 631-9763
Fax
(310) 631-6680
NPI assigned
Jun 25, 2007
Last updated
Jun 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Authorized official

Name
Dr. Matthew Harris, D.MIN
Title
Executive Director
Phone
(310) 631-9763

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MFC 18585 CA Primary

Addresses

Primary practice location

2640 Industry Way
Suites G and H
Lynwood, CA 90262-4000

Mailing address

2640 Industry Way
Suites G and H
Lynwood, CA 90262-4000
Phone (310) 631-9763

National Provider Directory

National Provider Directory
Tax ID family
Project Impact Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2640 Industry Way
Ste G
Lynwood, CA 90262
Phone (310) 631-9763

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1801092952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "address_2": "SUITES G AND H",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624000",
            "telephone_number": "310-631-9763",
            "fax_number": "310-631-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 INDUSTRY WAY",
            "address_2": "SUITES G AND H",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902624000",
            "telephone_number": "310-631-9763",
            "fax_number": "310-631-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROJECT IMPACT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "310-631-9763",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.MIN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "MFC 18585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.