FIRST IMPRESSIONS CUMMUNITY DEVELOPMENT CORP. (NPI# 1417330960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417330960 |
| Entity Type | Organization |
| Organization Name | FIRST IMPRESSIONS CUMMUNITY DEVELOPMENT CORP. |
| Practice Address |
20101 Nw 34th Ct Miami Gardens FL 33056-1768 |
| Practice Telephone | 3055257946 |
| Practice Fax Number | 3056201614 |
| Mailing Telephone | 3055257946 |
| Mailing Fax Number | 3056201614 |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |
| Authorized Official Name | MRS. SHATARIA BRIDGES-MOSS (OWNER) |
| Authorized Official Telephone | 3055257946 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
FL | Ambulatory Health Care Facilities | |
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | FL | Residential Treatment Facilities | |
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | FL | Residential Treatment Facilities |
| Street Address |
20101 NW 34TH CT |
| City | MIAMI GARDENS |
| State | FL |
| Zip Code | 33056-1768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912475898 | Dory Ailec Abellon Mederos | Behavior Technician | 3270 Nw 208 St, Miami Garden, FL 33056 | 2018-11-08 |
| 1356867121 | Sonya Hunter | Case Management | 2200 Nw 193rd Terrace, Miami, FL 33056 | 2017-08-14 |
| 1144759531 | Spirit Residential Group Home | Clinic/Center | 17311 N.w 33 Ct, Miami Gardens, FL 33056 | 2017-06-08 |
| 1942744735 | Medicode Network Solutions | Durable Medical Equipment & Medical Supplies | 16805 Nw 24 Ct, Miami, FL 33056 | 2016-12-13 |
| 1114317013 | Mental Health Counseling of South Florida LLC | Social Worker | 18656 Nw 47 Ave, #102 F, Miami Gardens, FL 33056 | 2015-01-29 |
| 1568713956 | A Sweet Adult Care Alf, Inc | Assisted Living Facility | 2751 Nw 209th Terra, Miami Gardens, FL 33056 | 2012-09-25 |
| 1093006660 | Gloria Jean Roan | Respiratory Therapist, Registered | 2320 Nw 187th Street, Miami Garden, FL 33056 | 2011-04-29 |
| 1891091690 | Barry M Gillman | Chiropractor | 17325 Nw 27th Avenue, Suite 111, Miami, FL 33056 | 2011-01-27 |
| 1245363381 | Wal-mart Stores, Inc. | Technician/Technologist | 19501 Northwest 27th Ave., Miami Gardens, FL 33056 | 2007-03-14 |
| 1689719213 | Great Care Pharmacy Inc | Pharmacy | 17560 Nw 27 Ave, Suite 107, Miami Gardens, FL 33056 | 2007-02-21 |
| Find all providers in zip 33056 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831748706 | The National Center for Life and Liberty | Residential Treatment Facility, Emotionally Disturbed Children | 13702 Green Isle Ter, Clermont, FL 34711-8426 | 2019-09-04 |
| 1881177509 | Sailfuture | Residential Treatment Facility, Emotionally Disturbed Children | 2900 68th Ave S, St Petersburg, FL 33712-5525 | 2018-09-09 |
| 1760892111 | Loving Arms Outreach, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 608 Nw 15th Ave, Pompano Beach, FL 33069-2829 | 2014-05-06 |
| 1689016560 | Alternate Group Care, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 20250 Sw 50th Pl, Southwest Ranches, FL 33332-1021 | 2013-07-22 |
| 1528304714 | Linda Newsome | Residential Treatment Facility, Emotionally Disturbed Children | 1454 Bent Oaks Blvd, Deland, FL 32724-8062 | 2012-12-17 |
| 1528327335 | G4s Youth Services LLC | Residential Treatment Facility, Emotionally Disturbed Children | 6302 Benjamin Rd Ste 400, Tampa, FL 33634-5116 | 2012-05-14 |
| 1003172073 | Esther's Group Home Corp. | Residential Treatment Facility, Emotionally Disturbed Children | 20115 Highland Lakes Blvd, N Miami Beach, FL 33179-2813 | 2012-04-04 |
| 1841584265 | D & R Rahabilitation Service Corp | Residential Treatment Facility, Emotionally Disturbed Children | 8567 Coral Way # 156, Miami, FL 33155-2335 | 2011-06-02 |
| 1003146887 | Sequel Tsi of Florida, LLC Daytona Transitional | Residential Treatment Facility, Emotionally Disturbed Children | 1386 Indian Lake Rd, Daytona Beach, FL 32124-1001 | 2009-12-30 |
| 1568795615 | Elite Behavioral Health Center | Residential Treatment Facility, Emotionally Disturbed Children | 611 Ne 13th St, Ft Lauderdale, FL 33304-1109 | 2009-09-08 |
| Find all providers with the same taxonomy | ||||
| City | MIAMI GARDENS |
| Zip Code | 33056 |
Please comment or provide details below to improve the information on FIRST IMPRESSIONS CUMMUNITY DEVELOPMENT CORP..
| 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.