Healthcare Provider Details

I. General information

NPI: 1790058733
Provider Name (Legal Business Name): SUPPORT UNLIMITED, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2012
Last Update Date: 01/27/2023
Certification Date: 09/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6249 EDGEWATER DRIVE V1, STE. 7
ORLANDO FL
32810-3281
US

IV. Provider business mailing address

PO BOX 608503
ORLANDO FL
32860-8503
US

V. Phone/Fax

Practice location:
  • Phone: 407-625-8228
  • Fax: 407-289-8801
Mailing address:
  • Phone: 407-625-8228
  • Fax: 407-289-8801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: REGINA PADGETT
Title or Position: PRESIDENT
Credential: LCSW
Phone: 407-625-8228