NPIMap

Organization Active NPI

Impact Behavior Health Services LLC.

  • Community/Behavioral Health Agency
  • Harvey, LA
National Provider Identifier
1821358300
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
IMPACT BEHAVIOR HEALTH SERVICES LLC.
Practice address
2439 Manhattan Blvd Ste 402
Harvey, LA 70058-5469
Phone
(504) 662-7617
Fax
(504) 218-7962
NPI assigned
May 18, 2012
Last updated
Nov 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Authorized official

Name
Mr. John Anthony Clark, MASTER DEGREENPI 1326412784
Title
Ceo
Phone
(504) 304-4097

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2439 Manhattan Blvd Ste 402
Harvey, LA 70058-5469

Mailing address

2439 Manhattan Blvd Ste 402
Harvey, LA 70058-5469
Phone (504) 304-4097

Other names 1

  • IMPACT BEHAVIOR HEALTYH SERRVICES LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

2439 Manhattan Blvd
Ste 402
Harvey, LA 70058
Phone (504) 304-4097

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

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1821358300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2439 MANHATTAN BLVD STE 402",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700585469",
            "telephone_number": "504-304-4097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2439 MANHATTAN BLVD STE 402",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700585469",
            "telephone_number": "504-662-7617",
            "fax_number": "504-218-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT BEHAVIOR HEALTH SERVICES LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-18",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "504-304-4097",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MASTER DEGREE"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMPACT BEHAVIOR HEALTYH SERRVICES LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Harvey, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.