INTERNAL MEDICINE AND PEDIATRICS ASSOCIATESOF TALLAHASSEE INC NPI 1982922829

NPI Information

NPI: 1982922829
Provider Name: INTERNAL MEDICINE AND PEDIATRICS ASSOCIATESOF TALLAHASSEE INC

Doing Business As: IMPACT BEHAVIORAL HEALTH LLC

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
1965 CAPITAL CIR NE
SUITE 102
TALLAHASSEE, FL
ZIP 32308
Phone: (850) 671-4600
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INTERNAL MEDICINE AND PEDIATRICS ASSOCIATESOF TALLAHASSEE INC is a substance abuse rehabilitation facility in Tallahassee, FL. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. INTERNAL MEDICINE AND PEDIATRICS ASSOCIATESOF TALLAHASSEE INC NPI is 1982922829. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Impact Behavioral Health Llc.

The provider's business location address is:

1965 CAPITAL CIR NE
SUITE 102
TALLAHASSEE, FL
ZIP 32308-401
Phone: (850) 671-4600
Fax: (850) 878-2863

The provider's authorized official is Yvette Mignon .
The authorized official title is Owner and has the following contact phone number (850) 656-2006.

The enumeration date for this NPI number is 5/16/2010 and was last updated on 12/1/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		8447	FLORIDA	No
2	101YM0800X	Counselor	Mental Health	8447	FLORIDA	No
3	104100000X	Social Worker		6702	FLORIDA	No
4	1041C0700X	Social Worker	Clinical	6702	FLORIDA	No
5	324500000X	Substance Abuse Rehabilitation Facility			FLORIDA	Yes
6	324500000X	Substance Abuse Rehabilitation Facility				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	600680931	OTHER	FLORIDA	MAGELLAN
2	8447	OTHER	FLORIDA	LICENSED MENTAL HEALTH COUNSELOR
3	648299630A	MEDICAID	GEORGIA
4	2386	OTHER	GEORGIA	LICENSED PROFESSIONAL COUNSELOR
5	003214900	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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