NPI 1053131417

Impact Residential Care LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Avon, IN

Practice location

Address: 8605 Talisker Dr, Avon, IN 46123-7288
Phone: (207) 347-1748

Authorised official

Name: Grace Uwase
Title: Owner
Phone: (207) 347-1748

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

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Registry record

NPI: 1053131417
Entity type: Organization
NPI issued: 11 Oct 2024
Record last updated: 11 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.