Impact Carolina Services,Inc

LBN: Impact Carolina Services,Inc
Impact Carolina Services,Inc is an health care organization with primary practice located at 1006 Union Road Suite B, Gastonia NC 28054-0000. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty. Impact Carolina Services,Inc can be contacted via phone (704) 864-8775, or through Adedokun, Joseph via phone (704) 732-2006.

Contact Information

Primary practice address
1006 Union Road Suite B Gastonia NC 28054-0000
Phone: (704) 864-8775
Fax: (980) 225-0549
Website:
Map and Directions
Authorized official contact:
Name: Adedokun, Joseph PH.D.
Phone: (704) 732-2006

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 795 North Carolina
Behavioral Health & Social Service Providers / Mental Health 101YM0800X C005215 North Carolina
Behavioral Health & Social Service Providers / Clinical 1041C0700X CD07873 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X NC1809906 North Carolina

Profile Details

NPI number 1780135681
LBN Legal business name Impact Carolina Services,Inc
DBA Doing business as
Authorized official Adedokun, Joseph PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 17th, 2016
Last updated Oct 17th, 2016 - about 10 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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Identifiers

StateTypeNumberIssuer
All States NPI 1780135681 NPPES
North Carolina MEDICAID 5918094
North Carolina MEDICAID 6008555

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