Healthcare Provider Details

I. General information

NPI: 1033846522
Provider Name (Legal Business Name): IMPACT HOME CARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ASH ST STE 102
GOLDSBORO NC
27530-3657
US

IV. Provider business mailing address

200 W ASH ST STE 102
GOLDSBORO NC
27530-3657
US

V. Phone/Fax

Practice location:
  • Phone: 919-440-8713
  • Fax:
Mailing address:
  • Phone: 919-988-8145
  • Fax: 919-648-2082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL LITTLE
Title or Position: DIRECTOR OF CARE
Credential:
Phone: 919-988-8145