Organization
IMPACT BEHAVIOR HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A CLARK (CEO)
(504) 304-4097
Entity
Organization
Contact information
Practice address
12147 COURSEY BLVD, SUITE B, BATON ROUGE, LA 70816-4410
(225) 771-8849
(225) 771-8876
Mailing address
1406 ESPLANADE AVE, NEW ORLEANS, LA 70116-1803
(504) 304-4097
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
LA
Other
Enumeration date
02/15/2016
Last updated
11/07/2020
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