IMPACT COMMUNTIY SERVICE LLC NPI 1184922916

NPI Information

  • NPI: 1184922916
  • Provider Name: IMPACT COMMUNTIY SERVICE LLC
  • Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
  • Entity Type: Organization
  • Address: 9801 CRYSTALLINE DR
    RENO, NV
    ZIP 89506
  • Phone: (775) 677-2640

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NPI Details

IMPACT COMMUNTIY SERVICE LLC is a residential treatment facility emotionally disturbed children in Reno, NV. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. IMPACT COMMUNTIY SERVICE LLC NPI is 1184922916. The provider is registered as an organization entity type.

The provider's business location address is:

9801 CRYSTALLINE DR
RENO, NV
ZIP 89506-566
Phone: (775) 677-2640

The provider's authorized official is Donald Wade Skipper .
The authorized official title is Basic Skills Trainer and has the following contact phone number (775) 378-6722.

The enumeration date for this NPI number is 3/2/2011 and was last updated on 3/2/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1322D00000XResidential Treatment Facility, Emotionally Disturbed ChildrenGF125403151NEVADAYes

What is NPI?

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This page was last updated on: 3/30/2025

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