IMPACT'S TRANSITIONAL LIFE-SKILL CENTER INC (NPI# 1669992400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669992400 |
| Entity Type | Organization |
| Organization Name | IMPACT'S TRANSITIONAL LIFE-SKILL CENTER INC |
| Practice Address |
4518 S Manhattan Ave Tampa FL 33611-2306 |
| Practice Telephone | (813) 693-5101 |
| Mailing Telephone | 8136935101 |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2017-06-22 |
| Authorized Official Name | KATHY GROSS (VICE PRESIDENT) |
| Authorized Official Telephone | 8136935101 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| Street Address |
4518 S MANHATTAN AVE |
| City | TAMPA |
| State | FL |
| Zip Code | 33611-2306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114105921 | Sydney's School | Psychologist | 4518 S Manhattan Ave, Tampa, FL 33611-2306 | 2008-02-04 |
| 1194332254 | Vanessa Ileann Anderson-alvarez | Behavior Technician | 4518 S Manhattan Ave, Tampa, FL 33611-2306 | 2020-09-23 |
| 1306358775 | Lillian Rose Block | Behavior Technician | 4518 S Manhattan Ave, Tampa, FL 33611-2306 | 2017-10-25 |
| 1710211495 | Danielle Carfore | Contractor | 4518 S Manhattan Ave, Tampa, FL 33611-2306 | 2009-09-28 |
| 1013241710 | Anita Maurer | Contractor | 4518 S Manhattan Ave, Tampa, FL 33611-2306 | 2009-09-28 |
| 1992039663 | Crystal Lagor | Behavioral Analyst | 4518 S Manhattan Ave, Tampa, FL 33611-2306 | 2009-09-28 |
| 1063746733 | Lauren Peterson | Contractor | 4518 S Manhattan Ave, Tampa, FL 33611-2306 | 2009-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912519224 | Health & Glow Primary Care & Med Spa LLC | Internal Medicine | 4331 S Manhattan Ave, Tampa, FL 33611 | 2020-08-18 |
| 1245867597 | Susannah M Bultron | Home Health | 1663 Williambrg Sq, 1663 Williambrg Sq, Tampa, FL 33611 | 2020-03-26 |
| 1265077499 | Jenna Davis | Counselor | 4517 S Shamrock Rd, Tampa, FL 33611 | 2019-11-12 |
| 1023585114 | Samantha Lee Hamlin | Dietitian, Registered | 4003 S West Shore Blvd, Apt 4810, Tampa, FL 33611 | 2018-10-27 |
| 1023502572 | Sunset Chiropractic P.a. | Chiropractor | 3826 South Dale Mabry Hwy, South Tampa, FL 33611 | 2018-06-19 |
| 1033654843 | Nicole A Devlieger | Specialist/Technologist | 4539 S Dale Mabry Hwy Ste 110, Tampa, FL 33611 | 2017-01-03 |
| 1740633064 | Charles Lindsey | Case Manager/Care Coordinator | 5215 South Westshore Blvd. #31, Tampa, FL 33611 | 2016-07-21 |
| 1699145078 | Sarah Milam | Physical Therapist | 3111 W.martin Luther King Jr Blvd, Suite # 500, Tampa, FL 33611 | 2015-09-29 |
| 1912399163 | Robert Robertson | Pharmacist | 4317 Gandy Blvd, Tampa, FL 33611 | 2015-02-25 |
| 1730514225 | Charles Samuel Mahan | Obstetrics & Gynecology | 3111 E. Fletcher Av., Tampa, FL 33611 | 2013-09-04 |
| Find all providers in zip 33611 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528361 | Where The Heart Is Home Care Services LLC | Day Training, Developmentally Disabled Services | 110 E Broad St Apt 204, Tampa, FL 33604-4132 | 2020-11-04 |
| 1417562257 | Peace of Mind Home Care Services | Day Training, Developmentally Disabled Services | 1102 Ray Charles Blvd Unit 314, Tampa, FL 33602-3050 | 2020-09-09 |
| 1871087080 | Guardian Haven Academy | Day Training, Developmentally Disabled Services | 3801 Corporex Park Dr Ste 200, Tampa, FL 33619-1136 | 2018-06-20 |
| 1902314214 | Ruthell Jenkins | Day Training, Developmentally Disabled Services | 3720 Williams Landing Cir Unit 208, Tampa, FL 33610-9130 | 2018-01-21 |
| 1396198917 | Shana Taylor Taylor | Day Training, Developmentally Disabled Services | 8005 Downpatrick Ct, Tampa, FL 33610-8074 | 2016-07-19 |
| 1386093144 | Merced Care Home LLC | Day Training, Developmentally Disabled Services | 4616 N Lincoln Ave, Tampa, FL 33614-6634 | 2016-06-11 |
| 1700231198 | Davides Care At Home, Inc. | Day Training, Developmentally Disabled Services | 20013 Satin Leaf Ave, Tampa, FL 33647-3714 | 2016-05-04 |
| 1548614597 | Agena Health LLC | Day Training, Developmentally Disabled Services | 8712 High St, Tampa, FL 33614-1619 | 2016-04-15 |
| 1629475496 | Hugo Vazquez | Day Training, Developmentally Disabled Services | 13927 Briardale Ln, Tampa, FL 33618-2115 | 2014-11-21 |
| 1881933570 | Eden Home Health | Day Training, Developmentally Disabled Services | 10018 N 23rd St, Tampa, FL 33612-7126 | 2013-01-31 |
| Find all providers in TAMPA | ||||
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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.