| Impact Behavioral Health Llc | |
|
1184 Mcgee Ct Ne Keizer OR 97303-9443 | |
| (971) 601-8042 | |
| Not Available |
| Full Name | Impact Behavioral Health Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1184 Mcgee Ct Ne, Keizer, Oregon |
| Authorized Official Name and Position | Eliane Mutesi (MANAGER) |
| Authorized Official Contact | 9716018042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Behavioral Health Llc 1184 Mcgee Ct Ne Keizer OR 97303-9443 Ph: (971) 601-8042 | Impact Behavioral Health Llc 1184 Mcgee Ct Ne Keizer OR 97303-9443 Ph: (971) 601-8042 |
| NPI Number | 1295512515 |
|---|---|
| Provider Enumeration Date | 09/11/2023 |
| Last Update Date | 06/07/2024 |
| Certification Date | 06/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295512515 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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