Provider Demographics
NPI:1447843743
Name:IMPACTFUL INSIGHTS LLC
Entity type:Organization
Organization Name:IMPACTFUL INSIGHTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS-MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-750-4189
Mailing Address - Street 1:113 E ROSA PARKS AVE
Mailing Address - Street 2:
Mailing Address - City:TUSKEGEE
Mailing Address - State:AL
Mailing Address - Zip Code:36083-1750
Mailing Address - Country:US
Mailing Address - Phone:334-750-4189
Mailing Address - Fax:
Practice Address - Street 1:113 E ROSA PARKS AVE
Practice Address - Street 2:
Practice Address - City:TUSKEGEE
Practice Address - State:AL
Practice Address - Zip Code:36083-1750
Practice Address - Country:US
Practice Address - Phone:334-750-4189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison HealthGroup - Multi-Specialty
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty