| Impact Behavior Supports, Inc | |
|
1016 E North Blvd Leesburg FL 34748-5348 | |
| (352) 874-2986 | |
| Not Available |
| Full Name | Impact Behavior Supports, Inc |
|---|---|
| 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 |
|---|---|
| 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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