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NPI Code Detail

MEDICARE: IMPACT LIVES HEALTH SERVICES, LLP

MEDICARE: IMPACT LIVES HEALTH SERVICES, LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1467399469
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMPACT LIVES HEALTH SERVICES, LLP
Provider Business Mailing Address
First Line : 1705 SECTION RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3313
Country : US
Telephone Number : 513-295-6696
Fax Number :
Provider Business Practice Location Address
First Line : 1705 SECTION RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45237-3313
Country : US
Telephone Number : 513-295-6696
Fax Number :
Authorized Official
Title or Position : CEO
Name : KEIANA ROGERS
Credential : CDCA
Telephone Number : 513-295-6696
Provider Enumeration Date : 04/29/2026
Last Update Date : 04/29/2026

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Directions to “IMPACT LIVES HEALTH SERVICES, LLP ” Practice Location

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