Impact Wellness Center Llc

LBN: Impact Wellness Center Llc
Impact Wellness Center Llc is an health care organization with primary practice located at 2700 Galena Ave , North Chesterfield VA 23237-4638. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty. Impact Wellness Center Llc can be contacted via phone (702) 754-9136, or through Stafford, Phillip C via phone (702) 754-9063.

Contact Information

Primary practice address
2700 Galena Ave North Chesterfield VA 23237-4638
Phone: (702) 754-9136
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Stafford, Phillip C
Phone: (702) 754-9063

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X
Behavioral Health & Social Service Providers / Counseling 103TC1900X
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X

Profile Details

NPI number 1205509205
LBN Legal business name Impact Wellness Center Llc
DBA Doing business as
Authorized official Stafford, Phillip C
Entity Organization
Organization subpart 1 No
Enumeration date Jul 27th, 2021
Last updated Jul 27th, 2021 - 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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