Provider Demographics
NPI:1154064582
Name:GREATER IMPACT HEALTH CARE, LLC
Entity Type:Organization
Organization Name:GREATER IMPACT HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZAINAB
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-239-6158
Mailing Address - Street 1:16975 ISLIP LOOP APT 303
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-3239
Mailing Address - Country:US
Mailing Address - Phone:571-239-6158
Mailing Address - Fax:
Practice Address - Street 1:16975 ISLIP LOOP APT 303
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-3239
Practice Address - Country:US
Practice Address - Phone:571-239-6158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities