# MAJOR IMPACT SUPPORT SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Major Impact Support Services, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952967887
- **Authorized official:** MR. CLAYTON LAMBERT MAJOR SR. MS (CO-OWNER)
- **Authorized official phone:** (239) 822-8401

## Contact information

- **Practice address:** 8875 HIDDEN RIVER PKWY, TAMPA, FL 33637-1035
- **Practice address phone:** (239) 226-4357
- **Practice address fax:** (239) 226-4352
- **Mailing address:** 1960 VELASCO ST STE J2, FORT MYERS, FL 33916-2761
- **Mailing address phone:** (239) 822-8472
- **Mailing address fax:** (239) 226-4352

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/16/2019
- **Last updated:** 05/16/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 003799000 | — | FL |