IMPACT LIVES CONSULTING GROUP LLC (NPI# 1578120440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578120440 |
| Entity Type | Organization |
| Organization Name | IMPACT LIVES CONSULTING GROUP LLC |
| Practice Address |
11613 Sw 216th St Miami FL 33170-2933 |
| Practice Telephone | 8004602152 |
| Practice Fax Number | 8004602152 |
| Mailing Telephone | 8004602152 |
| Mailing Fax Number | 8004602152 |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2019-05-24 |
| Authorized Official Name | JOLIE WOODSTOCK (DIRECTOR OF ACCOUNTING & H/R) |
| Authorized Official Telephone | 8004602152 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| Street Address |
11613 SW 216TH ST |
| City | MIAMI |
| State | FL |
| Zip Code | 33170-2933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760049639 | Dfz Marketing LLC | Clinic/Center | 11613 Sw 216th St, Miami, FL 33170-2933 | 2019-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972117224 | Beautiful Minds Medical Center LLC | Clinic/Center | 11045 Sw 216th Street, Unit 6, Miami, FL 33170 | 2020-09-03 |
| 1801414214 | Maria Del Carmen Acosta | Behavior Technician | 11270 Sw 219 St, Miami, FL 33170 | 2020-07-13 |
| 1912540857 | Ryan David Moore | Military Health Care Provider | Montereale 24, Aviano, PORDENONE 33170 | 2019-10-23 |
| 1982171633 | Arc Dialysis Perrine LLC | Clinic/Center | 22165 S Dixie Hwy, Miami, FL 33170 | 2018-10-31 |
| 1376019059 | Pw Group Home Inc. | Clinic/Center | 22931 Sw 114 Path, Miami, FL 33170 | 2018-10-19 |
| 1679062814 | Interdisciplinary Healthcare Services LLC | Assisted Living Facility | 12751 Sw 226 Street, Miami, FL 33170 | 2018-05-03 |
| 1861925836 | Aida Marmol | Behavior Technician | 23065 Sw 113 Passage, Miami, FL 33170 | 2017-04-06 |
| 1518404706 | Jessica Laurent | Nurse Practitioner | 13262 Sw 216 Terrace, Miami, FL 33170 | 2017-01-25 |
| 1871943266 | Dannisa Olafsen | Behavior Technician | 22851 Sw 157th Ave, Miami, FL 33170 | 2016-06-15 |
| 1639526262 | Priscilla Ruiz | Assistant Behavior Analyst | 22655 Sw 127th Ct, Miami, FL 33170 | 2016-05-24 |
| Find all providers in zip 33170 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
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| 1609439140 | Behavioral Health & Wellness of South Florida | Clinic/Center | 11285 Sw 211th St # 202, Miami, FL 33189-2211 | 2019-04-19 |
| 1013164417 | Therapeutic Options, Inc. | Clinic/Center | 3213 Sw 26th St, Miami, FL 33133-2025 | 2008-08-27 |
| 1104006824 | Good Samaritan Community Health, Inc. | Clinic/Center | 7701 Sw 98th St, Miami, FL 33156-2634 | 2007-11-09 |
| 1851455992 | The Devereux Foundation | Clinic/Center | 8410 Nw 53rd Terrace, Miami, FL 33166 | 2006-12-21 |
| 1235216243 | Pnd Medical Services Corp | Clinic/Center | 10491 N Kendall Dr, Suite F 210, Miami, FL 33176-1533 | 2006-11-01 |
| 1952360620 | New Horizons Community Mental Health Center, Inc | Clinic/Center | 1469 Nw 36th St, Miami, FL 33142-5557 | 2006-03-21 |
| 1003391970 | Medisun Community Health Center Inc | Clinic/Center | 180 Nw 62nd St, Miami, FL 33150-4543 | 2018-09-26 |
| 1396276846 | Miami Rescue Mission Clinic Inc | Clinic/Center | 2015 Nw 1st Ave, Miami, FL 33127-4901 | 2017-03-27 |
| 1609267277 | The Florida Clinic, Inc. | Clinic/Center | 10000 Sw 56th St Ste 17, Miami, FL 33165-7162 | 2015-02-18 |
| Find all providers in MIAMI | ||||
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| 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.