| Impact Behavior Health Services Llc. | |
|
4700 Wichers Dr Marrero Suite 205b Marrero LA 70072-3041 | |
| (504) 407-0907 | |
| (504) 333-6252 |
| Full Name | Impact Behavior Health Services Llc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4700 Wichers Dr, Marrero, Louisiana |
| Authorized Official Name and Position | John A Clark (CEO) |
| Authorized Official Contact | 5044070709 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Behavior Health Services Llc. 4700 Wicher Dr. 4700 Wichers Dr Suite 205b Marrero LA 70072 Ph: (504) 407-0709 | Impact Behavior Health Services Llc. 4700 Wichers Dr Marrero Suite 205b Marrero LA 70072-3041 Ph: (504) 407-0907 |
| NPI Number | 1023484706 |
|---|---|
| Provider Enumeration Date | 08/17/2015 |
| Last Update Date | 11/02/2020 |
| Certification Date | 11/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023484706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Louisiana) | Primary |
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