SUPPORT INDEPENDENT LIVING
NPI 1306590260
Clinic/Center - Developmental Disabilities in Fort Walton Beach, FL

Active since February 09, 2022
11 RACETRACK RD NE STE C2, FORT WALTON BEACH, FL 32547(850) 259-7190 Get Directions Write a Review

NPPES record last updated: February 9, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Support Independent Living NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUPPORT INDEPENDENT LIVING (NPI 1306590260) is a healthcare organization registered as a developmental disabilities in Fort Walton Beach, Florida and active in the NPI registry since February 2022. The organization lists Brenda F Marrier, Owner, as its authorized official.

NPPES Registry Identity

NPI1306590260
Entity TypeOrganization
Primary Taxonomy261QD1600X
Legal Business NameSUPPORT INDEPENDENT LIVING
Location Address11 RACETRACK RD NE STE C2Fort Walton Beach, FL 32547-1867
Mailing Address11 Racetrack Rd Ne Ste C2Fort Walton Beach, FL 32547-1867 · (850) 259-7190 · Fax (850) 862-4849
Organization SubpartNo
Authorized OfficialBrenda F MarrierOwner · (850) 259-7190
Enumeration DateFebruary 9, 2022
NPPES CertifiedFebruary 9, 2022
NPI 1306590260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Developmental DisabilitiesAmbulatory Health Care Facilities
Taxonomy Code261QD1600X
Definition

An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

11 RACETRACK RD NE STE C2, Fort Walton Beach, FL 32547

Other Names 1

Doing Business AsSupport Independent Living

Other Identifiers 1

Medicaid684509696FL

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1306590260, enumerated as an "organization" on February 09, 2022.

The provider is located at 11 RACETRACK RD NE STE C2 FORT WALTON BEACH, FL 32547 and the phone number is (850) 259-7190.

Clinic/Center with taxonomy code 261QD1600X and a focus in Developmental Disabilities.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.