OrganizationActive
Impact Home Care Services LLC
NPI 1215682505 · Developmentally Disabled Services Day Training Agency · Jacksonville, FL
Provider details
- NPI number
- 1215682505
- Entity type
- Organization
- Primary specialty
- Developmentally Disabled Services Day Training AgencyAgencies
- Organization subpart
- No
- Authorized official
- Shawan Davis, Owner(904) 415-7665
Specialties & taxonomies
Agencies
- In Home Supportive Care Agency253Z00000X
Agencies
- Non-emergency Medical Transport (VAN)343900000X
Transportation Services
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
4720 Salisbury Rd
Unit 110
Jacksonville, FL 32256-6101
Phone: (904) 415-7665
Street-level locationGet directions
Mailing address
6700 Bowden Rd Unit 1104
Jacksonville, FL 32216-3672
Registry dates
- Enumerated
- 2022-02-16
- Last updated
- 2022-02-16
- Certified
- 2022-01-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.