Healthcare Provider Details

I. General information

NPI: 1518538529
Provider Name (Legal Business Name): PUZZLE PIECES SUPPORT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2021
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 FLORAMAR TER
NEW PORT RICHEY FL
34652-3302
US

IV. Provider business mailing address

11700 N 58TH ST STE D
TEMPLE TERRACE FL
33617-1692
US

V. Phone/Fax

Practice location:
  • Phone: 727-378-2424
  • Fax:
Mailing address:
  • Phone: 813-605-5555
  • Fax: 888-790-7002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KECHIA J HOLLOWAY
Title or Position: CEO
Credential: CBHCMS.0100302
Phone: 813-605-5555