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 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Allopathic & Osteopathic Physicians / Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is the primary health care specialty. Impact Carolina Services Inc can be contacted via phone (704) 864-8775, or through Adedokun, Joseph O 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 O PH.D.
Phone: (704) 732-2006

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X North Carolina
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X North Carolina

Profile Details

NPI number 1861941049
LBN Legal business name Impact Carolina Services Inc
DBA Doing business as
Authorized official Adedokun, Joseph O PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Sep 28th, 2016
Last updated Sep 28th, 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 1861941049 NPPES
North Carolina MEDICAID 6006650

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