Organization
IMPACT FOR DEVELOPMENTAL EDUCATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHY S BEELER (EXECUTIVE DIRECTOR)
(239) 334-6160
Entity
Organization
Contact information
Practice address
1650 MEDICAL LANE SUITE 4, FORT MYERS, FL 33907-1116
(239) 334-6160
(239) 334-1339
Mailing address
P.O. BOX 51319, FORT MYERS, FL 33994-1119
(239) 334-6160
(239) 334-1339
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105037500
—
FL
Enumeration date
09/28/2022
Last updated
03/07/2023
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