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IMPACT BEHAVIORAL SERVICES LLC
NPI 1265162846
Community/Behavioral Health in Fort Wayne, IN

Active since June 15, 2022
4606 E STATE BLVD, FORT WAYNE, IN 46815(260) 740-5139 Get Directions Write a Review

NPPES record last updated: June 15, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Impact Behavioral Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMPACT BEHAVIORAL SERVICES LLC (NPI 1265162846) is a healthcare organization registered as a community/behavioral health in Fort Wayne, Indiana and active in the NPI registry since June 2022. The organization lists Shawn A Wallace, Owner, as its authorized official.

NPPES Registry Identity

NPI1265162846
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameIMPACT BEHAVIORAL SERVICES LLC
Location Address4606 E STATE BLVDFort Wayne, IN 46815-6993
Mailing Address2918 Elmwood CtFort Wayne, IN 46804-6100 · (260) 740-5139
Phone(260) 740-5139
Organization SubpartNo
Authorized OfficialShawn A WallaceOwner · (260) 740-5139
Enumeration DateJune 15, 2022
NPPES CertifiedJune 15, 2022
✔ NPI 1265162846 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
4606 E STATE BLVD, Fort Wayne, IN 46815
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID SLYBY D.D.S.
Dentist
4606 E STATE BLVD, B
FORT WAYNE, IN 46815
Allen County (260) 484-0725
DAVID G. SLYBY D.D.S. P.C.
Dentist
4606 E STATE BLVD, B
FORT WAYNE, IN 46815
Allen County (260) 484-0725

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Impact Behavioral Services LLC's NPI number?

The NPI number for Impact Behavioral Services LLC is 1265162846. It was assigned to this organization in the NPPES registry on June 15, 2022.

Where is Impact Behavioral Services LLC located?

Impact Behavioral Services LLC is located at 4606 E State Blvd, Fort Wayne, IN 46815. The listed phone number is (260) 740-5139.

What is Impact Behavioral Services LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Impact Behavioral Services LLC was last updated on June 15, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.