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General NPI Number Information
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NPI Number | 1932704517
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Entity Type | Organization
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Legal Business Name | IMPAQ TRANSPORTATION AND COMMUNITY SERVICES, LLC
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 14727 BOLDERE LN
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City | HOUSTON
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State | TX
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Zip | 77049-1654
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Country | US
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Telephone | 832-275-9063
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Fax | 281-754-4869
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Provider Business Mailing Address
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Address Line | 3695 HIGHWAY 6 STE 233
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City | SUGAR LAND
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State | TX
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Zip | 77478-4403
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Country | US
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Telephone | 832-275-9063
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Fax | 281-754-4869
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Authorized Official
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Title or Position | OWNER
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Name | LASHAY DUPREE
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Credential | LMSW, CCM
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Telephone | 832-275-9063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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