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General NPI Number Information
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NPI Number | 1083205603
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Entity Type | Organization
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Legal Business Name | IMPACT CENTRAL FLORIDA INC
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 6121 SILVER STAR RD
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City | ORLANDO
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State | FL
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Zip | 32808-4244
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Country | US
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Telephone | 407-797-8625
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Fax |
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Provider Business Mailing Address
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Address Line | 2394 KEY AVE
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City | SANFORD
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State | FL
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Zip | 32771-4601
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Country | US
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Telephone | 407-797-8625
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SASHA WASHINGTON
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Credential |
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Telephone | 407-797-8625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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