OrganizationActive
Parent Support, LLC
NPI 1124476064 · Mental Illness Community Based Residential Treatment Facility · Davenport, FL
Provider details
- NPI number
- 1124476064
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Vickki-Ann Samuel, Medical Director
- License
- CARF ACCREDITED (FL)
Practice location
146 Sunset View Dr.
Davenport, FL 33896
Phone: (407) 901-4000
Fax: (407) 930-4830
Mailing address
146 Sunset View Dr.
Davenport, FL 33896
Registry dates
- Enumerated
- 2016-06-01
- Last updated
- 2016-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.