Provider Demographics
NPI:1760125736
Name:IMPACT HOME HEALTH LLC
Entity Type:Organization
Organization Name:IMPACT HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CFO/ALT ADMIN/DON
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-224-2024
Mailing Address - Street 1:13219 DOTSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4308
Mailing Address - Country:US
Mailing Address - Phone:979-224-2024
Mailing Address - Fax:
Practice Address - Street 1:13219 DOTSON RD STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4308
Practice Address - Country:US
Practice Address - Phone:979-224-2024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty