Organization
IMPACT BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CLARK (OWNER)
(504) 407-0709
Entity
Organization
Contact information
Practice address
4700 WICHERS DR STE 205, MARRERO, LA 70072-3054
(504) 407-0709
Mailing address
4700 WICHERS DR STE 205, MARRERO, LA 70072-3054
(504) 407-0709
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
LA
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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