Yolande Collman

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

5751-3-FA Issued in FL

Practice address

2724 Conch Hollow Dr
Brandon, FL 33511-7348

Phone

(201) 478-1688

NPI assigned

Jan 26, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lifelong Learners Academy LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Brandon, FL
  • NPI 1568268803

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1114670544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 CONCH HOLLOW DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117348",
            "telephone_number": "201-478-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 CONCH HOLLOW DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117348",
            "telephone_number": "201-478-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLMAN",
        "first_name": "YOLANDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "5751-3-FA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024700900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "yolande@lifelonglearnersacademy.com",
            "affiliation": "N",
            "endpointDescription": "protect against signature based attacks",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2724 Conch Hollow Dr",
            "city": "Brandon",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335117348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shania Coleman
• Shunika Ison Coleman
• Heidi Collier, LICSW
• Cynthia Lou Collins, R.N.
• Paulina Yvette Collins
• Nancy Ellen Colman, APRN
• Christian Alfonso Colon Berly, MD
• Ivelisse Colon Martinez, RMHC-I
• Olga Marie Colon-Mercado, MD
• Antonio Colon

• All providers in Brandon, FL
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.