Organization
IMPAC
Active
Other names
I.M.P.A.C. by Alternative Home Care Specialists, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL KEPHART (CEO)
(337) 233-0545
Entity
Organization
Contact information
Practice address
1531 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-1825
(337) 233-0545
(337) 233-2490
Mailing address
1220 ERASTE LANDRY RD, LAFAYETTE, LA 70506-3046
(337) 233-0545
(337) 233-2490
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2132172
—
LA
Enumeration date
04/14/2011
Last updated
10/04/2022
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