Ignite Clinical Wellness Group

LBN: Ignite Clinical Wellness Group
Ignite Clinical Wellness Group is an health care organization with primary practice located at 5600 Goodman Rd Ste G , Olive Branch MS 38654-7002. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Ignite Clinical Wellness Group can be contacted via phone (662) 985-4101, or through Roach, Derrick O via phone (901) 859-2071.

Contact Information

Primary practice address
5600 Goodman Rd Ste G Olive Branch MS 38654-7002
Phone: (662) 985-4101
Fax: (662) 404-7288
Website:
Map and Directions
Authorized official contact:
Name: Roach, Derrick O
Phone: (901) 859-2071

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1184305666
LBN Legal business name Ignite Clinical Wellness Group
DBA Doing business as
Authorized official Roach, Derrick O
Entity Organization
Organization subpart 1 No
Enumeration date Jul 27th, 2023
Last updated Jul 27th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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