Organization
IMPACT COMMUNITY SERVICES LLC
Active
Organization
IMPACT COMMUNITY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVONTE CHRISTOPHER (OWNER)
(702) 505-3213
Entity
Organization
Contact information
Practice address
8204 ELMBROOK DR STE 112, DALLAS, TX 75247-4017
(702) 505-3213
Mailing address
8204 ELMBROOK DR STE 112, DALLAS, TX 75247-4017
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
09/25/2023
Last updated
07/29/2024
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