OrganizationActive
Parent Support, LLC
NPI 1528415247 · Mental Illness Community Based Residential Treatment Facility · Davenport, FL
Provider details
- NPI number
- 1528415247
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Vickki-Ann Samuel, Medical Director(407) 901-4000
- License
- CARF ACCREDITED (FL)
Specialties & taxonomies
- Mental Illness Community Based Residential Treatment FacilityPrimary320800000XLicense CARF ACCREDITED (FL)
Residential Treatment Facilities
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 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
389 Sand Ridge Dr
Davenport, FL 33896-4717
Phone: (407) 901-4000
Fax: (407) 930-4830
Street-level locationGet directions
Mailing address
389 Sand Ridge Dr
Davenport, FL 33896-4717
Other names (DBA / former)
- Doing business as
- Heart Transformation Treatment
Registry dates
- Enumerated
- 2016-05-23
- Last updated
- 2016-05-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.