OrganizationActive
Populus Primus LLC
NPI 1003625112 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Wimauma, FL
Provider details
- NPI number
- 1003625112
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Tanisha Foster, Owner(727) 226-2196
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Profile Score
Established profile(55/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
14523 Callen Glen Way
Wimauma, FL 33598-6179
Phone: (727) 226-2196
Street-level locationGet directions
Mailing address
14523 Callen Glen Way
Wimauma, FL 33598-6179
Registry dates
- Enumerated
- 2025-01-03
- Last updated
- 2025-01-03
- Certified
- 2025-01-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.