Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI # | 1083317010 |
| LBN Legal business name | COLLECTIVE IMPACT SERVICES LLC |
| Authorized official | JULIE CLARK - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/27/2023 |
| Last updated | 04/17/2023 - About 3 years ago |
| Identifiers | n/a |
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