IMPACT OUTPATIENT PROGRAM LLC NPI 1972176113

NPI Information

  • NPI: 1972176113
  • Provider Name: IMPACT OUTPATIENT PROGRAM LLC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • :
  • CLIA Number: 18D2305810
  • Address: 1200 N BARDSTOWN RD STE A2
    MT WASHINGTON, KY
    ZIP 40047
  • Phone: (502) 439-2248

Map and Directions

Get Directions

NPI Details

IMPACT OUTPATIENT PROGRAM LLC is a substance abuse rehabilitation facility in Mt Washington, KY. 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. IMPACT OUTPATIENT PROGRAM LLC NPI is 1972176113. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

1200 N BARDSTOWN RD STE A2
MT WASHINGTON, KY
ZIP 40047-669
Phone: (502) 439-2248

The provider's authorized official is Brian Thornsberry .
The authorized official title is Manager and has the following contact phone number (502) 439-2248.

The CLIA number assigned to this NPI record is 18D2305810 - other - substance use facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/23/2021 and was last updated on 9/2/2025.

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
1324500000XSubstance Abuse Rehabilitation FacilityYes

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI