PROJECT IMPACT INC. (NPI# 1801092952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801092952 |
| Entity Type | Organization |
| Organization Name | PROJECT IMPACT INC. |
| Practice Address |
2640 Industry Way Suites G and H Lynwood CA 90262-4000 |
| Practice Telephone | 3106319763 |
| Practice Fax Number | 3106316680 |
| Mailing Telephone | 3106319763 |
| Mailing Fax Number | 3106316680 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2014-06-02 |
| Authorized Official Name | DR. MATTHEW HARRIS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3106319763 |
| Authorized Official Credential | D.MIN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | MFC 18585 | CA | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942524194 | Project Impact Inc. | Case Management | 7119 Village Way, Houston, TX 77087-2904 | 2010-03-17 |
| Street Address |
2640 INDUSTRY WAY SUITES G AND H |
| City | LYNWOOD |
| State | CA |
| Zip Code | 90262-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831173970 | Russell F. Lim | Psychiatry & Neurology | 2640 Industry Way, Lynwood, CA 90262-4284 | 2005-12-02 |
| 1467053603 | Jaquenette Miller | Case Manager/Care Coordinator | 2640 Industry Way, Lynwood, CA 90262-4284 | 2020-11-04 |
| 1720685233 | Russell Smith | Case Manager/Care Coordinator | 2640 Industry Way, Lynwood, CA 90262-4284 | 2020-10-07 |
| 1629675343 | Destiny Williams-panell | Case Manager/Care Coordinator | 2640 Industry Way, Lynwood, CA 90262-4284 | 2020-10-06 |
| 1104438589 | Elizabeth Navarro | Case Manager/Care Coordinator | 2640 Industry Way, Lynwood, CA 90262-4284 | 2020-08-18 |
| 1265056162 | Debbie Diane Smith | Case Manager/Care Coordinator | 2640 Industry Way, Lynwood, CA 90262-4284 | 2020-06-05 |
| 1538782354 | Jason Douglas Delacuz | Licensed Vocational Nurse | 2640 Industry Way, Lynwood, CA 90262-4284 | 2020-05-27 |
| 1700418548 | Lidia Minerva Haefele | Counselor | 2640 Industry Way, Lynwood, CA 90262-4284 | 2020-02-10 |
| 1396377495 | Adam Castillo | Counselor | 2640 Industry Way, Lynwood, CA 90262-4284 | 2020-02-06 |
| 1073145355 | Aaron Sanderlin | Case Manager/Care Coordinator | 2640 Industry Way, Lynwood, CA 90262-4284 | 2020-02-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811546062 | Sheila Maxine Wilkins | Technician | 3940 Palm Ave, Lynwood, CA 90262 | 2019-09-10 |
| 1891344669 | Chezoma Latissue Davis | Technician | 4255 Niland St, Lynwood, CA 90262 | 2019-09-05 |
| 1295223345 | Scla Comprehensive Surgical Medical Group, Inc. | Clinic/Center | 3628 E Imperial Hwy Ste 204, Lynwood, CA 90262 | 2018-04-24 |
| 1891213807 | Grecia Veronica Nunez | Case Manager/Care Coordinator | 3680 E. Imperial Highway, Suite 200, Lynwood, CA 90262 | 2017-08-30 |
| 1134643448 | Angelica Jazmin Alonso Cortes | Case Manager/Care Coordinator | 2610 Industry Way Suite A, Lynwood, CA 90262 | 2017-07-28 |
| 1134594997 | Corinne Palma | Counselor | 11705 S. Alameda St., Lynwood, CA 90262 | 2015-12-04 |
| 1891175550 | Nancy Bremmer | Counselor | 10705 S. Alameda Street, Los Angels, CA 90262 | 2015-06-08 |
| 1588041347 | Jennifer Montoya | Case Management | 5433 E. Pelleur St., Lynwood, CA 90262 | 2015-04-30 |
| 1124440060 | Susana Gyek Goy | Chiropractor | 11123 Long Beach Blvd. Suite 5, Lynwood Health Center, Lynwood, CA 90262 | 2014-01-13 |
| 1215368956 | Baart Community Healthcare | Clinic/Center | 11315 S. Atlantic Blvd., Lynwood, CA 90262 | 2013-12-05 |
| Find all providers in zip 90262 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578990644 | His Gifts Inc | Community/Behavioral Health | 12204 South San Pedro Street Los Angeles, Ca 90061, 10910 Long Beach Blvd Suite 103, Lynwood, CA 90262 | 2013-10-03 |
| 1578800280 | Shields for Families | Community/Behavioral Health | 11705 Deputy Yamamoto Pl Ste A, Lynwood, CA 90262-4031 | 2013-01-15 |
| 1437404340 | Atlantic Recovery Services | Community/Behavioral Health | 11387 Bullis Rd, Lynwood, CA 90262-3660 | 2012-07-17 |
| 1972864858 | Children's Institute, Inc | Community/Behavioral Health | 2610 Industry Way Blvd., Suite C, Lynwood, CA 90262-4283 | 2012-06-06 |
| 1073809687 | Atlantic Recovery Services | Community/Behavioral Health | 3898 Abbott Rd, Lynwood, CA 90262-2106 | 2011-06-22 |
| 1902192511 | Atlantic Recovery Services | Community/Behavioral Health | 11300 Spruce St, Lynwood, CA 90262-3629 | 2011-06-22 |
| 1386930089 | Atlantic Recovery Services | Community/Behavioral Health | 11300 Wright Rd, Lynwood, CA 90262-3126 | 2011-06-22 |
| 1326334939 | Atlantic Recovery Services | Community/Behavioral Health | 4050 E Imperial Hwy, Lynwood, CA 90262-2853 | 2011-06-22 |
| 1093009037 | Atlantic Recovery Services | Community/Behavioral Health | 5246 Martin Luther King Jr Blvd, Lynwood, CA 90262-3903 | 2011-06-07 |
| 1376778860 | Shields for Families | Community/Behavioral Health | 2620 Industry Way Ste E-f, Lynwood, CA 90262-4024 | 2009-05-27 |
| Find all providers in LYNWOOD | ||||
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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.