Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Impact Life Group Home LLC

Organization Developmentally Disabled Services Day Training Agency · NPI 1932059359

Impact Life Group Home LLC is a Developmentally Disabled Services Day Training Agency in Charlotte, North Carolina. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6412 Baltray Rd
Charlotte, NC 28278-6640
Phone: (704) 749-4556
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Developmentally Disabled Services Day Training Agency (primary) Taxonomy 251C00000X

Record details

NPI number1932059359
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jebolisa Ilukwe — Director · (704) 749-4556
NPI enumeratedFebruary 3, 2026
Last updated in NPPESFebruary 3, 2026
Certification dateFebruary 3, 2026
Mailing address6412 Baltray Rd, Charlotte, NC 28278-6640

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