Organization
IMPACT BEHAVIOR HEALTH SERVICES LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY B CLARK BS (CEO)
(504) 222-4938
Entity
Organization
Contact information
Practice address
9504 N IH 35 STE 311, SAN ANTONIO, TX 78233-6617
(504) 407-0709
(504) 333-6252
Mailing address
9504 N IH 35 STE 311, SAN ANTONIO, TX 78233-6617
(504) 407-0709
(504) 333-6252
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
TX
Other
Enumeration date
08/17/2015
Last updated
08/17/2015
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