OrganizationActive
Impact Outpatient Program LLC
NPI 1972176113 · Substance Abuse Rehabilitation Facility · Mt Washington, KY
Provider details
- NPI number
- 1972176113
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Authorized official
- Brian Thornsberry, Manager
Practice location
1200 N Bardstown Rd Ste A2
Mt Washington, KY 40047-7669
Phone: (502) 439-2248
Mailing address
1200 N Bardstown Rd Ste A2
Mt Washington, KY 40047-7669
Registry dates
- Enumerated
- 2021-07-23
- Last updated
- 2025-09-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.