NPIMap

Organization Active NPI

Impact Behavioral Healthcare LLC

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1841039997
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
IMPACT BEHAVIORAL HEALTHCARE LLC
Practice address
3625 Fairview Ave
Baltimore, MD 21216-1329
Phone
(443) 449-5051
NPI assigned
May 20, 2024
Organization subpart
Yes
Parent organization
IMPACT BEHAVIORAL HEALTHCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Muhammad Ayaz Jarral
Title
Executive Director
Phone
(443) 255-9973

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

3625 Fairview Ave
Baltimore, MD 21216-1329

Mailing address

3455 Wilkens Ave
Baltimore, MD 21229-5213

National Provider Directory

National Provider Directory
Tax ID family
Impact Behavioral Healthcare5 organizations share this tax ID, including this one
Part of
Impact Behavioral Healthcare

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1841039997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 WILKENS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 FAIRVIEW AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212161329",
            "telephone_number": "443-449-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT BEHAVIORAL HEALTHCARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMPACT BEHAVIORAL HEALTHCARE LLC",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "JARRAL",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_middle_name": "AYAZ",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-255-9973"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.