| Asd Impact Inc | |
|
6601 Washington Ave Racine WI 53406-3923 | |
| (262) 880-5864 | |
| Not Available |
| Full Name | Asd Impact Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6601 Washington Ave, Racine, Wisconsin |
| Authorized Official Name and Position | Erricka Border (OWNER) |
| Authorized Official Contact | 2628805864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Asd Impact Inc 1017 Stratford Ct Racine WI 53406-7001 Ph: () - | Asd Impact Inc 6601 Washington Ave Racine WI 53406-3923 Ph: (262) 880-5864 |
| NPI Number | 1366858292 |
|---|---|
| Provider Enumeration Date | 07/11/2014 |
| Last Update Date | 07/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366858292 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 128554121 (Wisconsin) | Primary |
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