| Impact 360 Aba Solutions | |
|
2601 Cartwright Rd # D233 Missouri City TX 77459-2613 | |
| (281) 241-9183 | |
| Not Available |
| Full Name | Impact 360 Aba Solutions |
|---|---|
| Speciality | Behavior Technician |
| Location | 2601 Cartwright Rd # D233, Missouri City, Texas |
| Authorized Official Name and Position | Eboni Zandranette Davis (PROGRAM MANAGER) |
| Authorized Official Contact | 2812419183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact 360 Aba Solutions 2601 Cartwright Rd # D233 Missouri City TX 77459-2613 Ph: (281) 241-9183 | Impact 360 Aba Solutions 2601 Cartwright Rd # D233 Missouri City TX 77459-2613 Ph: (281) 241-9183 |
| NPI Number | 1346833647 |
|---|---|
| Provider Enumeration Date | 02/17/2021 |
| Last Update Date | 10/31/2023 |
| Certification Date | 10/31/2023 |
| Medicare PECOS PAC ID | 9830545680 |
|---|---|
| Medicare Enrollment ID | O20231030003818 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346833647 | NPI | - | NPPES |
| Provider Name | Ti Onna Watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417373390 PECOS PAC ID: 0840660643 Enrollment ID: I20230111002567 |
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