Organization
IMPACT PREVENTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN K. GOODWIN OCPS II (HUMAN RESOURCES/CO OWNER)
(740) 646-1922
Entity
Organization
Contact information
Practice address
22 PRIVATE DRIVE 2824 APT B, SOUTH POINT, OH 45680-7109
(740) 646-1922
Mailing address
PO BOX 809, SOUTH POINT, OH 45680-0809
(740) 646-1922
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
OH
Other
Enumeration date
07/15/2016
Last updated
07/15/2016
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