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IMPACT OUTPATIENT PROGRAM LLC
NPI 1972176113
Substance Abuse Rehabilitation Facility in Mt Washington, KY

Active since July 23, 2021CLIA 18D2305810 · Waiver
1200 N BARDSTOWN RD STE A2, MT WASHINGTON, KY 40047(502) 439-2248 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Sep 2, 2025, Jan 1, 2024, Jul 23, 2021 (3 updates tracked since 2021).

About Impact Outpatient Program Llc NPPES

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

IMPACT OUTPATIENT PROGRAM LLC (NPI 1972176113), doing business as Robert Alexander Center For Recovery, is a healthcare organization registered as a substance abuse rehabilitation facility in Mt Washington, Kentucky and active in the NPI registry since July 2021. The organization holds a CLIA Waiver certificate valid through June 5, 2028 and lists Brian Thornsberry, Manager, as its authorized official.

NPPES Registry Identity

NPI1972176113
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameIMPACT OUTPATIENT PROGRAM LLC
Location Address1200 N BARDSTOWN RD STE A2Mt Washington, KY 40047-7669
Mailing Address1200 N Bardstown Rd Ste A2Mt Washington, KY 40047-7669
Phone(502) 439-2248
Organization SubpartNo
Authorized OfficialBrian ThornsberryManager · (502) 439-2248
Enumeration DateJuly 23, 2021
Last NPPES UpdateSeptember 2, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 1, 2024
✔ NPI 1972176113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
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.
1200 N BARDSTOWN RD STE A2, Mt Washington, KY 40047
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Other Names 1

Doing Business AsRobert Alexander Center For Recovery

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 18D2305810

Impact Outpatient Program, LLC · Mount Washington, KY
Active · expires Jun 5, 2028
CLIA Number18D2305810
Laboratory TypeSubstance Use Facility
Certificate Effective DateJune 6, 2026
Certificate Expiration DateJune 5, 2028
Laboratory DirectorDr. Jordan Calabrese
Laboratory Phone(502) 439-2248
Laboratory LocationImpact Outpatient Program, LLC1200 N Bardstown Road, Suite A-2, Mount Washington, KY 40047
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Outpatient Program LLC's NPI number?

The NPI number for Impact Outpatient Program LLC is 1972176113. It was assigned to this organization in the NPPES registry on July 23, 2021. The provider is doing business as Robert Alexander Center For Recovery.

Where is Impact Outpatient Program LLC located?

Impact Outpatient Program LLC is located at 1200 N Bardstown Rd Ste A2, Mt Washington, KY 40047. The listed phone number is (502) 439-2248.

What is Impact Outpatient Program LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Impact Outpatient Program LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2305810) is associated with this NPI, valid through June 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Impact Outpatient Program LLC was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.