Impact Behavior Supports, Inc | |
1016 E North Blvd Leesburg FL 34748-5348 | |
(352) 874-2986 | |
Not Available |
Full Name | Impact Behavior Supports, Inc |
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Speciality | Community/behavioral Health |
Location | 1016 E North Blvd, Leesburg, Florida |
Authorized Official Name and Position | Jocelyn Mitchell (PRESIDENT) |
Authorized Official Contact | 3528742986 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Impact Behavior Supports, Inc 1016 E North Blvd Leesburg FL 34748-5348 Ph: (352) 874-2986 | Impact Behavior Supports, Inc 1016 E North Blvd Leesburg FL 34748-5348 Ph: (352) 874-2986 |
NPI Number | 1144844119 |
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Provider Enumeration Date | 06/04/2020 |
Last Update Date | 06/04/2020 |
Certification Date | 06/04/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144844119 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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