Impact Carolina Services
LBN: Impact Carolina Services
Impact Carolina Services is an health care organization with primary practice located at 1552 Union Rd Suite C, Gastonia NC 28054-5523. The organization recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Psychiatry, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Allopathic & Osteopathic Physicians / Psychiatry is the primary health care specialty.
Impact Carolina Services can be contacted via phone (704) 852-9210, or through Adedokun, Joseph via phone (704) 732-2006.
Contact Information
Primary practice address
1552 Union Rd Suite C
Gastonia NC 28054-5523
Phone: (704) 852-9210
Fax: (704) 852-9211
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 795 | North Carolina |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C002728 | North Carolina |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | NC 93-00472 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 5004878 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 5004910 | North Carolina |
Profile Details
| NPI number | 1629311063 |
|---|---|
| LBN Legal business name | Impact Carolina Services |
| DBA Doing business as | |
| Authorized official | Adedokun, Joseph PH.D. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 4th, 2013 |
| Last updated | Apr 4th, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629311063 | NPPES |
| North Carolina | MEDICAID | 5004910 | |
| North Carolina | MEDICAID | 6003129 | |
| North Carolina | MEDICAID | 891036Y | |
| North Carolina | MEDICAID | 5004878 | |
| North Carolina | MEDICAID | 6111767 |
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