Provider Demographics
NPI:1053197251
Name:HEALTH IMPACT PARTNERS
Entity type:Organization
Organization Name:HEALTH IMPACT PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAM
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:816-867-0867
Mailing Address - Street 1:312 SW GREENWICH DR # 174
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-4408
Mailing Address - Country:US
Mailing Address - Phone:816-867-0867
Mailing Address - Fax:
Practice Address - Street 1:201 N FOREST AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64050-2696
Practice Address - Country:US
Practice Address - Phone:816-867-0867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335G00000XSuppliersMedical Foods Supplier
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Multi-Specialty