| Impact Autism Services | |
|
316 Brook Park Pl Forest VA 24551-2766 | |
| (434) 477-4176 | |
| Not Available |
| Full Name | Impact Autism Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 316 Brook Park Pl, Forest, Virginia |
| Authorized Official Name and Position | Adam Pavao (CO-OWNER) |
| Authorized Official Contact | 4344774176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Autism Services 316 Brook Park Pl Forest VA 24551-2766 Ph: (434) 477-4176 | Impact Autism Services 316 Brook Park Pl Forest VA 24551-2766 Ph: (434) 477-4176 |
| NPI Number | 1750950671 |
|---|---|
| Provider Enumeration Date | 06/24/2021 |
| Last Update Date | 06/24/2021 |
| Certification Date | 06/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750950671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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