MEDICARE: FIRST IMPRESSIONS SUPPORTED LIVING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1154273894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST IMPRESSIONS SUPPORTED LIVING LLC

Provider Business Mailing Address
First Line	:	3817 WILLYS PKWY
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-1214
Country	:	US
Telephone Number	:	419-917-8094
Fax Number	:

Provider Business Practice Location Address
First Line	:	3817 WILLYS PKWY
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-1214
Country	:	US
Telephone Number	:	419-917-8094
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. NATALL M TRIPLETT
Credential	:
Telephone Number	:	419-917-8094

Provider Enumeration Date	:	02/13/2026
Last Update Date	:	02/13/2026

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