| NPI | 1821358300 |
|---|---|
| Former Legal Business Name | IMPACT BEHAVIOR HEALTYH SERRVICES LLC |
| Entity Type | Organization |
| Authorized Contact | JOHN ANTHONY CLARK CEO 504-304-4097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2023-11-29 |