# IMPERIAL CONNECTIONS SUPPORT PROGRAMS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184112427
- **Authorized official:** KIMERLYN JOHNSON ED.S. (OWNER)
- **Authorized official phone:** (813) 395-9950

## Contact information

- **Practice address:** 9806 N CONNECHUSETT RD, TAMPA, FL 33617
- **Practice address phone:** (813) 395-9950
- **Practice address fax:** (813) 364-6474
- **Mailing address:** 5450 BRUCE B DOWNS BLVD STE 328, WESLEY CHAPEL, FL 33544-8616
- **Mailing address phone:** (813) 395-9950
- **Mailing address fax:** (813) 364-6474

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 235233 | FL | Yes |
| 253Z00000X | In Home Supportive Care Agency | 022101700 | FL | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 022101700 | FL | — |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | 022101700 | FL | — |

## Other

- **Enumeration date:** 04/23/2018
- **Last updated:** 05/30/2018