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Major Impact Support Services, Inc
Children's Substance Abuse Rehabilitation Facility in Fort Myers, Florida
NPI 1093468274

Major Impact Support Services, Inc is a Children's Substance Abuse Rehabilitation Facility based in Fort Myers, FL and is specialized in Substance Abuse Treatment, Children. Major Impact Support Services, Inc practices in Fort Myers, FL. The NPI Number for Major Impact Support Services, Inc is 1093468274 and holds a License No. (Florida).

The current practice location address for Major Impact Support Services, Inc is 1960 Velasco St Ste J2, Fort Myers, FL and can be reached out via phone at 239-226-4657 and via fax at 239-226-4352.

Location: 1960 Velasco St Ste J2, Fort Myers, FL, 33916-2761
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1093468274
Provider Name
Major Impact Support Services, Inc
Credential
Provider Entity Type
Organization
Address
1960 Velasco St Ste J2, Fort Myers, FL, 33916-2761
Phone Number
239-226-4657
Fax Number
239-226-4352
Provider Enumeration Date
01/28/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1960 Velasco St Ste J2
City
Fort Myers
State
Florida
Zip
33916-2761
Phone Number
239-226-4657
Fax Number
239-226-4352
person
Provider Business Mailing Address Details
Address
1960 Velasco St Ste J2
City
Fort Myers
State
Florida
Zip
33916-2761
Phone Number
239-226-4657
Fax Number
239-226-4352
person
Provider's Taxonomy Details 1
Type
Agencies
Classification
Community/Behavioral Health
Speciality
-
Taxonomy
251S00000X
License No.
()
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
person
Provider's Taxonomy Details 5
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
Substance Abuse Treatment, Children
Taxonomy
3245S0500X
License No.
()
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.
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