Provider Demographics
NPI:1972351054
Name:HIGH IMPACT PERFORMANCE & RECOVERY, LLC.
Entity type:Organization
Organization Name:HIGH IMPACT PERFORMANCE & RECOVERY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:WABLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-704-6172
Mailing Address - Street 1:122 SPRING ST STE C5
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-1534
Mailing Address - Country:US
Mailing Address - Phone:860-704-6973
Mailing Address - Fax:860-863-4035
Practice Address - Street 1:122 SPRING ST STE C5
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-1534
Practice Address - Country:US
Practice Address - Phone:860-704-6973
Practice Address - Fax:860-863-4035
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED BEHAVIORAL HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies