Provider Demographics
NPI:1083405732
Name:ADMIN IMPACT
Entity type:Organization
Organization Name:ADMIN IMPACT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:ORDAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-206-3636
Mailing Address - Street 1:4795 BEATTY DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2308
Mailing Address - Country:US
Mailing Address - Phone:909-206-3636
Mailing Address - Fax:
Practice Address - Street 1:4795 BEATTY DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2308
Practice Address - Country:US
Practice Address - Phone:909-206-3636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADMIN IMPACT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care