Imperial Connections Support Programs, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

235233 Issued in FL

Legal business name

IMPERIAL CONNECTIONS SUPPORT PROGRAMS, LLC

Practice address

9806 N Connechusett Rd
Tampa, FL 33617

Phone

(813) 395-9950

Fax

(813) 364-6474

NPI assigned

Apr 23, 2018

Organization subpart

No

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

Authorized official

Name

Kimerlyn Johnson, ED.S.

Title

Owner

Phone

(813) 395-9950

Specialties & licenses 4

Addresses

Other identifiers 1

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527638400000",
    "number": "1184112427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 BRUCE B DOWNS BLVD STE 328",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335448616",
            "telephone_number": "813-395-9950",
            "fax_number": "813-364-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9806 N CONNECHUSETT RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33617",
            "telephone_number": "813-395-9950",
            "fax_number": "813-364-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL CONNECTIONS SUPPORT PROGRAMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-05-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIMERLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-395-9950",
        "authorized_official_credential": "ED.S."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "235233",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "022101700",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "FL",
            "license": "022101700",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "FL",
            "license": "022101700",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022101700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Tampa, FL
• Providers in Tampa, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.