Provider Demographics
NPI:1720761349
Name:CARE IMPACT 2 LLC
Entity Type:Organization
Organization Name:CARE IMPACT 2 LLC
Other - Org Name:CARE IMPACT PLUS RICHMOND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:RAUSCHENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:804-677-0415
Mailing Address - Street 1:2847 PENN FOREST BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4373
Mailing Address - Country:US
Mailing Address - Phone:804-905-7257
Mailing Address - Fax:
Practice Address - Street 1:5030 SADLER PL STE 102
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-6146
Practice Address - Country:US
Practice Address - Phone:180-467-7041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health