| Impact | |
|
152 E Main St # 106 Rigby ID 83442-1418 | |
| (208) 522-8899 | |
| (208) 522-6596 |
| Full Name | Impact |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 152 E Main St # 106, Rigby, Idaho |
| Authorized Official Name and Position | Bruce W Hampton (ADMINISTRATOR) |
| Authorized Official Contact | 2085228899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact 152 E Main St # 106 Rigby ID 83442-1418 Ph: (208) 522-8899 | Impact 152 E Main St # 106 Rigby ID 83442-1418 Ph: (208) 522-8899 |
| NPI Number | 1043427446 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 05/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043427446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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Impact Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 152 E Main St Ste 106, Rigby, ID 83442 Phone: 208-745-7831 Fax: 208-745-0658 |