| NPI | 1669846879 |
|---|---|
| Doing Business As | IMPACT BEHAVIOR HEALTH SERVICE |
| Entity Type | Organization |
| Authorized Contact | TRACY ELIZABETH CLARK Counselor 504-329-3755 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2015-11-26 |
| Last Update Date | 2015-11-26 |