| Impact Behavior Health Services Llc | |
|
12147 Coursey Blvd Baton Rouge LA 70816-4410 | |
| (225) 771-8849 | |
| (225) 771-8876 |
| Full Name | Impact Behavior Health Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12147 Coursey Blvd, Baton Rouge, Louisiana |
| Authorized Official Name and Position | John Anthony Clark (CEO) |
| Authorized Official Contact | 2257718849 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Behavior Health Services Llc 12147 Coursey Blvd Baton Rouge LA 70816-4410 Ph: (225) 771-8849 | Impact Behavior Health Services Llc 12147 Coursey Blvd Baton Rouge LA 70816-4410 Ph: (225) 771-8849 |
| NPI Number | 1023481322 |
|---|---|
| Provider Enumeration Date | 11/09/2015 |
| Last Update Date | 11/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023481322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6260 (Louisiana) | Primary |
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