Impact Wellness Center LLC
NPI 1093579054 · Comprehensive Outpatient Rehabilitation Facility (CORF) · Lakeside, AZ
Impact Wellness Center LLC is a Comprehensive Outpatient Rehabilitation Facility (CORF) organization in Lakeside, AZ (NPI 1093579054).
Provider details
- NPI number
- 1093579054
- Entity type
- Organization
- Primary specialty
- Comprehensive Outpatient Rehabilitation Facility (CORF)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Charles Wade, Owner(615) 720-8088
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-02-09
- Last updated
- 2024-05-01
- Certified
- 2024-05-01
Frequently asked questions
- What is Impact Wellness Center LLC's NPI number?
- Impact Wellness Center LLC's National Provider Identifier (NPI) is 1093579054, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Impact Wellness Center LLC?
- Impact Wellness Center LLC is classified in the NPPES registry as Comprehensive Outpatient Rehabilitation Facility (CORF) (Ambulatory Health Care Facilities).
- Where is Impact Wellness Center LLC located?
- Impact Wellness Center LLC's practice location on file with NPPES is 3179 W White Mountain Blvd, Lakeside, AZ 85929-6146.
- What is Impact Wellness Center LLC's phone number?
- The practice phone number listed in the NPPES registry for Impact Wellness Center LLC is (615) 720-8088.
- Who is the authorized official for Impact Wellness Center LLC?
- The authorized official listed on Impact Wellness Center LLC's NPPES record is Charles Wade, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Impact Wellness Center LLC's NPI active?
- Yes — Impact Wellness Center LLC's NPI (1093579054) is active in the NPPES registry as of the last update on 2024-05-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.