IMPACT COMMUNTIY SERVICE LLC (NPI# 1184922916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184922916 |
| Entity Type | Organization |
| Organization Name | IMPACT COMMUNTIY SERVICE LLC |
| Practice Address |
9801 Crystalline Dr Reno NV 89506-7566 |
| Practice Telephone | 7756772640 |
| Mailing Telephone | 7756772640 |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2011-03-02 |
| Authorized Official Name | MR. DONALD WADE SKIPPER (BASIC SKILLS TRAINER) |
| Authorized Official Telephone | 7753786722 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | GF125403151 | NV | Residential Treatment Facilities |
| Street Address |
9801 CRYSTALLINE DR |
| City | RENO |
| State | NV |
| Zip Code | 89506-7566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871890848 | Thomas Peter Diquarto | Counselor | 9801 Crystalline Dr, Reno, NV 89506-7566 | 2011-02-27 |
| 1528348539 | Project Up-lift, LLC | Community/Behavioral Health | 9801 Crystalline Dr, Reno, NV 89506-7566 | 2011-08-22 |
| 1093004574 | Michael Jones | Student in an Organized Health Care Education/Training Program | 9801 Crystalline Dr, Reno, NV 89506-7566 | 2011-04-05 |
| 1033417175 | Vestige Project, LLC | Community/Behavioral Health | 9801 Crystalline Dr, Reno, NV 89506-7566 | 2011-03-13 |
| 1093013740 | Jimi Anthony Vesely | Counselor | 9801 Crystalline Dr, Reno, NV 89506-7566 | 2011-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394547 | Megan Harris | Contractor | 7935 Key Largo Drive, Reno, NV 89506 | 2018-04-30 |
| 1528573227 | Jennifer Ann Woolf | Nurse Practitioner | 8165 Fire Opal Lane, Reno, NV 89506 | 2017-12-05 |
| 1912422957 | Trucare Health Services, LLC | Nurse Practitioner | 9930 Rising Sun Ct, Reno, NV 89506 | 2017-08-10 |
| 1326499856 | Kenia Barba | Social Worker | 745 W. Moana Ln, Reno, NV 89506 | 2016-06-27 |
| 1881070639 | Stephanie King | Speech-Language Pathologist | 14355 Murdoch Dr, Reno, NV 89506 | 2015-08-04 |
| 1396156378 | Raymond Bernard Smith Jr. | Behavior Technician | 200 Limber Pine Dr #15, Reno, NV 89506 | 2014-05-13 |
| 1770824344 | Margie Vancil | Counselor | 1660 Jewel Ridge Ct, Reno, NV 89506 | 2013-03-07 |
| 1275880502 | Erin Lee Coleman | Rehabilitation Practitioner | 13225 Mt Whitney St, Reno, NV 89506 | 2012-08-06 |
| 1336422567 | Maria Theresa Tech | Pharmacist | 305 Lemmons Drive, Reno, NV 89506 | 2011-09-23 |
| 1659662633 | Ryan Patrick Toomey | Counselor | 4056 Anthony James Ct, Reno, NV 89506 | 2011-04-26 |
| Find all providers in zip 89506 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215305818 | Levada House LLC | Residential Treatment Facility, Emotionally Disturbed Children | 3905 Clear Acre Ln Apt 27, Reno, NV 89512-1283 | 2015-09-13 |
| 1679639132 | Hand Up Homes for Youth | Residential Treatment Facility, Emotionally Disturbed Children | 2725 Yori Ave, Reno, NV 89502-4325 | 2006-12-29 |
| 1902199458 | Aaron J Holcomb | Residential Treatment Facility, Emotionally Disturbed Children | 255 W Moana Ln Ste 104, Reno, NV 89509-4942 | 2011-05-17 |
| 1568783942 | Jc Family Services | Residential Treatment Facility, Emotionally Disturbed Children | 2370 Ridge Field Trl, Reno, NV 89523-6803 | 2010-06-19 |
| 1578739157 | Hand Up Homes for Youth Nevada | Residential Treatment Facility, Emotionally Disturbed Children | 2725 Yori Ave, Reno, NV 89502-4325 | 2008-05-05 |
| 1336353101 | Koinonia Foster Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1050 Bible Way, Reno, NV 89502 | 2007-05-10 |
| 1962548990 | Beverly J. Paschal, Ma, Mft | Residential Treatment Facility, Emotionally Disturbed Children | 3670 Grant Dr, Suite 103-a, Reno, NV 89509-5309 | 2007-01-29 |
| 1811064272 | State of Nevada | Residential Treatment Facility, Emotionally Disturbed Children | 2655 Enterprise Rd, Reno, NV 89512-1666 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891282786 | Avenues 2 Success | Residential Treatment Facility, Emotionally Disturbed Children | 9520 Chanticleer Ct, Las Vegas, NV 89129-7858 | 2018-04-17 |
| 1639423064 | Sunny Day Home Health | Residential Treatment Facility, Emotionally Disturbed Children | 1712 Sagebrush Ranch Way, N Las Vegas, NV 89081-6718 | 2012-11-07 |
| 1093030017 | Unepected Changes | Residential Treatment Facility, Emotionally Disturbed Children | 428 Marion Dr, Las Vegas, NV 89110-3473 | 2010-04-01 |
| 1245567486 | Luvin' Kare Transitional Services | Residential Treatment Facility, Emotionally Disturbed Children | 217 Delighted Ave, North Las Vegas, NV 89031-1395 | 2009-11-09 |
| 1679703805 | Horizon Academy LLC | Residential Treatment Facility, Emotionally Disturbed Children | Hc 70 Box 531, Amargosa Valley, NV 89020-9600 | 2009-07-22 |
| 1174766612 | Carol Ellen Harrison | Residential Treatment Facility, Emotionally Disturbed Children | 1700 Buckthorn Ct, Minden, NV 89423-4127 | 2009-04-14 |
| 1700046372 | London Family and Children's Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2026 Silverton Dr, Henderson, NV 89074-1550 | 2008-06-16 |
| 1588821938 | Focal Point Academy | Residential Treatment Facility, Emotionally Disturbed Children | 560 W Mesquite Blvd, Mesquite, NV 89027-5137 | 2008-05-21 |
| 1306024773 | Father Flanagans Boys' Town | Residential Treatment Facility, Emotionally Disturbed Children | 8090 Flanagan Dr, Las Vegas, NV 89131-0200 | 2008-02-07 |
| 1215115688 | Father Flanagans Boys' Home | Residential Treatment Facility, Emotionally Disturbed Children | 8110 Flanagan Dr, Las Vegas, NV 89131-0200 | 2008-02-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on IMPACT COMMUNTIY SERVICE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.