NPIMap

Organization Active NPI

Impact Behavioral Health Services

  • Community/Behavioral Health Agency
  • Marrero, LA
National Provider Identifier
1285008839
Registry record updated Nov 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
IMPACT BEHAVIORAL HEALTH SERVICES
Practice address
4700 Wichers Dr Ste 205
Marrero, LA 70072-3054
Phone
(504) 407-0709
NPI assigned
Nov 19, 2015
Last updated
Nov 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Clark
Title
Owner
Phone
(504) 407-0709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X LA Primary

Addresses

Primary practice location

4700 Wichers Dr Ste 205
Marrero, LA 70072-3054

Mailing address

4700 Wichers Dr Ste 205
Marrero, LA 70072-3054
Phone (504) 407-0709

National Provider Directory

National Provider Directory
Tax ID family
Impact Behavior Health Service3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4700 Wichers Dr
Ste 205
Marrero, LA 70072
Phone (504) 407-0709

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1285008839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WICHERS DR STE 205",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723054",
            "telephone_number": "504-407-0709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WICHERS DR STE 205",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723054",
            "telephone_number": "504-407-0709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-407-0709"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.