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Organization

IMPACT FOR DEVELOPMENTAL EDUCATION, INC

Active
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Organization

IMPACT FOR DEVELOPMENTAL EDUCATION, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAXINE GIBBS (EXECUTIVE DIRECTOR)
(239) 628-1061
Entity
Organization

Contact information

Practice address
1650 MEDICAL LANE SUITE 4, FORT MYERS, FL 33907-1116
(239) 334-6160
(239) 334-1339
Mailing address
1650 MEDICAL LN STE 4, FORT MYERS, FL 33907-1116
(239) 628-1061

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
05/28/2026
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