OrganizationActive
Innovative Support Services, LLC
NPI 1184923054 · Case Management Agency · Lakeland, FL
Provider details
- NPI number
- 1184923054
- Entity type
- Organization
- Primary specialty
- Case Management AgencyAgencies
- Organization subpart
- No
- Authorized official
- Stephanie Kirnes, Executive Director(863) 904-8820
Specialties & taxonomies
Agencies
- Counselor101Y00000X
Behavioral Health & Social Service Providers
- Social Worker104100000X
Behavioral Health & Social Service Providers
- Public Health or Welfare Agency251K00000X
Agencies
- Supports Brokerage Agency251X00000X
Agencies
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs 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
310 Modest St
Lakeland, FL 33805-3123
Phone: (863) 904-8820
Fax: (866) 271-5349
Street-level locationGet directions
Mailing address
Po Box 2253
Eaton Park, FL 33840-2253
Registry dates
- Enumerated
- 2011-03-18
- Last updated
- 2011-03-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.