Provider Demographics
NPI:1932704517
Name:IMPAQ TRANSPORTATION AND COMMUNITY SERVICES, LLC
Entity Type:Organization
Organization Name:IMPAQ TRANSPORTATION AND COMMUNITY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LASHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPREE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CCM
Authorized Official - Phone:832-275-9063
Mailing Address - Street 1:3695 HIGHWAY 6 STE 233
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4403
Mailing Address - Country:US
Mailing Address - Phone:832-275-9063
Mailing Address - Fax:281-754-4869
Practice Address - Street 1:14727 BOLDERE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-1654
Practice Address - Country:US
Practice Address - Phone:832-275-9063
Practice Address - Fax:281-754-4869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty