FOOT PRINT TO SUCCESS CLUBHOUSE INC. (NPI# 1336583178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336583178 |
| Entity Type | Organization |
| Organization Name | FOOT PRINT TO SUCCESS CLUBHOUSE INC. |
| Practice Address |
3511 Nw 8th Ave Ste 7 Pompano Beach FL 33064-3055 |
| Practice Telephone | 9546578010 |
| Practice Fax Number | 9546578046 |
| Mailing Telephone | 9546578010 |
| Mailing Fax Number | 9546578046 |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2013-04-24 |
| Authorized Official Name | MRS. BARBARA JANE HARMON (CEO/ PRESIDENT) |
| Authorized Official Telephone | 9546578010 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251X00000X | Supports Brokerage | Agencies |
| Street Address |
3511 NW 8TH AVE STE 7 |
| City | POMPANO BEACH |
| State | FL |
| Zip Code | 33064-3055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790398865 | I Heart Senior and Disable Services LLC | Day Training, Developmentally Disabled Services | 4331 Ne 6th Ave, Pompano Beach, FL 33064 | 2020-08-28 |
| 1912554437 | Nada Boskovic Md Pa | Internal Medicine | 1 W Sample Road, Suite 305, Pompano Beach, FL 33064 | 2019-08-20 |
| 1922562933 | Bless Medical Center Corp | Family Medicine | 440 E Sample Road Suite 107, Pompano Beach, FL 33064 | 2019-01-23 |
| 1568932598 | Cloann Joseph | Occupational Therapy Assistant | 401 E Sample Road, Deerfield Beach, FL 33064 | 2018-12-03 |
| 1255808788 | Select Rehab | Skilled Nursing Facility | 401 Sample Road, Pompano Beach, FL 33064 | 2018-11-02 |
| 1699283515 | Nancy Emilia Santiago | Behavior Technician | 600 Nw 33 St, Pompano Beach, FL 33064 | 2018-01-12 |
| 1194248112 | Mark Walter Gruber I | Counselor | 100 E Sample Rd., #320, Pompano Beach, FL 33064 | 2017-07-21 |
| 1699221531 | Precision Construction & Design Services Inc | Contractor | 1711 B Nw 33 Street, Pompano Beach, FL 33064 | 2016-08-31 |
| 1841645587 | Julia Kyung Yoo, Inc | Point of Service | 4510 N. Federal Hwy, Lighthouse Point, FL 33064 | 2016-05-02 |
| 1487050969 | Michael Sassine | Podiatrist | 2100 Ne 36th St Ste 203, Lighthouse Point, FL 33064 | 2014-11-12 |
| Find all providers in zip 33064 | ||||
| Taxonomy Code | 251X00000X |
| Grouping | Agencies |
| Classification | Supports Brokerage |
| A provider of service/function that assists participating individuals to make informed decisions about what will work best for them is consistent with their needs and reflects their individual circumstances. Serving as the agent of the individual, the service is available to assist in identifying immediate and long-term needs, developing options to meet those needs and accessing identified supports and services and may include assistance with recruiting, screening, hiring, and training in-home support providers. A family or person-centered planning approach is used. Supports Brokerage offers practical skills training to enable families and individuals to remain independent. Examples of skills training include providing information on recruiting and hiring personal care workers, managing personal care workers and providing information on effective communication and problem solving. The service/function provides sufficient information to assure that individuals understand the responsibilities involved with self-direction and assist in the development of an effective back-up and emergency plan. Plans may elect to fulfill the requirement of this service/function using a self-directed case manager or creating a distinct service. The Supports Brokerage documents the need for assistive services, planning for and documenting the use of excess funds and locating and maintaining services. |
| Notes: Source: CMS Independence Plus Waiver template. [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235686783 | Ican Benefit Group | Supports Brokerage | 2251 North Federal Highway, Pompano Beach, FL 33062 | 2016-09-01 |
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| 1467936807 | Total Care Florida, Inc. | Supports Brokerage | 6801 Lake Worth Rd Ste 302, Greenacres, FL 33467-2966 | 2018-09-21 |
| 1538642681 | Insuring Sources, Inc. | Supports Brokerage | 7031 Sw 60th St, Miami, FL 33143-1835 | 2018-09-13 |
| 1346777588 | Premier Revenue Partners LLC | Supports Brokerage | 10231 Cove Lake Dr, Orlando, FL 32836-3757 | 2017-05-18 |
| 1003366063 | Premier Revenue Solutions LLC | Supports Brokerage | 1155 S Congress Ave Ste C, Palm Springs, FL 33406-5114 | 2016-10-13 |
| 1225484421 | Armchair Insurance and Tax Services, LLC | Supports Brokerage | 4530 Nw 36th St Apt 102, Lauderdale Lakes, FL 33319-6431 | 2016-05-06 |
| 1659741627 | Jimmie Dean Canole | Supports Brokerage | 2979 S Hwy A1a, Unit 224, Melbourne Beach, FL 32951-2881 | 2015-10-02 |
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| City | POMPANO BEACH |
| Zip Code | 33064 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.