Provider Demographics
NPI:1598375305
Name:IMPACTFUL HUMAN SERVICES LLC
Entity Type:Organization
Organization Name:IMPACTFUL HUMAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCNEIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-500-4742
Mailing Address - Street 1:1055 WESTLAKES DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-2410
Mailing Address - Country:US
Mailing Address - Phone:877-500-4742
Mailing Address - Fax:877-500-4742
Practice Address - Street 1:1055 WESTLAKES DR STE 3003
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-2410
Practice Address - Country:US
Practice Address - Phone:877-500-4742
Practice Address - Fax:877-500-4742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities