Impact's Transitional Life-Skill Center Inc

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

IMPACT'S TRANSITIONAL LIFE-SKILL CENTER INC

Practice address

909 Bryan Rd
Brandon, FL 33511-6145

Phone

(813) 693-5101

NPI assigned

Jun 22, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathy Gross

Title

Vice President

Phone

(813) 693-5101

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Colette Stibich

  • Day Training/Habilitation Specialist
  • Brandon, FL
  • NPI 1255088035
  NPD

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669992400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 BRYAN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116145",
            "telephone_number": "813-693-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 BRYAN RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116145",
            "telephone_number": "813-693-5101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4518 S Manhattan Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336112306",
            "country_code": "US",
            "telephone_number": "813-693-5101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "909 Bryan Rd",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335116145",
            "country_code": "US",
            "telephone_number": "813-693-5101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IMPACT'S TRANSITIONAL LIFE-SKILL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "813-693-5101"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Iden, MSW
• Beverly Iglesias, REGISTERED NURSE
• Kasarachi C Ihedoro, OD
• Haroon Ilyas, MD
• Imad Al-Nakshabendi M D P a
• Enrico Impreso, RPT
• In Focus Eye Care LLC
• Jean Paul Inesta Rivera, MD
• Infinite Tender Loving Care
• Jacquelyn Vanessa Ingar

• Adult Day Care Clinic/Center in Brandon, FL
• Providers in Brandon, FL by specialty
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.