Organization
IMPACT WELLNESS CENTER,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN PRIDGEON (PRESIDENT/ EXECUTIVE DIRECTOR)
(702) 586-5001
Entity
Organization
Contact information
Practice address
8991 W FLAMINGO RD STE 105, LAS VEGAS, NV 89147-0439
(702) 586-5001
(702) 664-0508
Mailing address
8991 W FLAMINGO RD STE 105, LAS VEGAS, NV 89147-0439
(702) 586-5001
(702) 664-0508
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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