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

Impact Life Residential Care

Organization Intellectual Disabilities Intermediate Care Facility · NPI 1699589010

Impact Life Residential Care is an Intellectual Disabilities Intermediate Care Facility in Richmond, Virginia. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

3203 Maury St
Richmond, VA 23224
Phone: (804) 833-6052
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X

Record details

NPI number1699589010
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Olufunmi Johnson — Ceo · (804) 833-6052
Other names N/A
NPI enumeratedFebruary 5, 2025
Last updated in NPPESFebruary 5, 2025
Certification dateJanuary 31, 2025
Mailing address3203 Maury St, Richmond, VA 23224

Other providers in Richmond