Organization
MAJOR IMPACT SUPPORT SERVICES, INC
Active
Other names
Major Impact Support Services, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAYTON LAMBERT MAJOR SR. MS (CO-OWNER)
(239) 822-8401
Entity
Organization
Contact information
Practice address
8875 HIDDEN RIVER PKWY, TAMPA, FL 33637-1035
(239) 226-4357
(239) 226-4352
Mailing address
1960 VELASCO ST STE J2, FORT MYERS, FL 33916-2761
(239) 822-8472
(239) 226-4352
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003799000
—
FL
Enumeration date
05/16/2019
Last updated
05/16/2019
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