Organization
IMPACT'S TRANSITIONAL LIFE-SKILL CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY GROSS (VICE PRESIDENT)
(813) 693-5101
Entity
Organization
Contact information
Practice address
909 BRYAN RD, BRANDON, FL 33511-6145
(813) 693-5101
Mailing address
909 BRYAN RD, BRANDON, FL 33511-6145
(813) 693-5101
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
06/22/2017
Last updated
07/21/2022
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