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General NPI Number Information
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NPI Number | 1720761349
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Entity Type | Organization
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Legal Business Name | CARE IMPACT 2 LLC
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Dates
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Enumeration Date | 08/10/2023
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | 5030 SADLER PL STE 102
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City | GLEN ALLEN
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State | VA
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Zip | 23060-6146
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Country | US
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Telephone | 180-467-7041
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Fax |
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Provider Business Mailing Address
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Address Line | 2847 PENN FOREST BLVD STE 201
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City | ROANOKE
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State | VA
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Zip | 24018-4373
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Country | US
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Telephone | 804-905-7257
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JENNIFER ANNE RAUSCHENBERG
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Credential | OTR/L
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Telephone | 804-677-0415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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