| Impact | |
|
3080 Jamestown Dr Gastonia NC 28054-6056 | |
| (704) 718-3480 | |
| (704) 852-4488 |
| Full Name | Impact |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3080 Jamestown Dr, Gastonia, North Carolina |
| Authorized Official Name and Position | Joseph Adedokun (CEO) |
| Authorized Official Contact | 7047183480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact 3080 Jamestown Dr Gastonia NC 28054-6056 Ph: (704) 718-3480 | Impact 3080 Jamestown Dr Gastonia NC 28054-6056 Ph: (704) 718-3480 |
| NPI Number | 1194973586 |
|---|---|
| Provider Enumeration Date | 08/28/2008 |
| Last Update Date | 08/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194973586 | NPI | - | NPPES |
| 6111767 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 795 (North Carolina) | Primary |
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