Organization
IMPACT HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH LAVINIA (ADMINISTRATOR)
(832) 529-7370
Entity
Organization
Contact information
Practice address
802 LAKE HAVEN CT, HIGHLAND VLG, TX 75077-6478
(832) 529-7370
Mailing address
802 LAKE HAVEN CT, HIGHLAND VLG, TX 75077-6478
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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