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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

IMPACT WELLNESS LLC
NPI 1356254973
Community/Behavioral Health in Jacksonville, FL

Active since September 24, 2026
12420 ROCHFORD LN, JACKSONVILLE, FL 32225(904) 540-4722 Get Directions Write a Review

NPPES record added: September 24, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Impact Wellness Llc NPPES

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

IMPACT WELLNESS LLC (NPI 1356254973) is a healthcare organization registered as a community/behavioral health in Jacksonville, Florida and active in the NPI registry since September 2026. The organization lists Charles Gilley, President Owner, as its authorized official.

NPPES Registry Identity

NPI1356254973
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameIMPACT WELLNESS LLC
Location Address12420 ROCHFORD LNJacksonville, FL 32225-4611
Mailing Address1005 Southern Hills DrOrange Park, FL 32065-2652
Phone(904) 540-4722
Organization SubpartNo
Authorized OfficialCharles GilleyPresident Owner · (904) 540-4722
Enumeration DateSeptember 24, 2026
NPPES CertifiedSeptember 24, 2026
✔ NPI 1356254973 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
12420 ROCHFORD LN, Jacksonville, FL 32225
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Impact Wellness LLC's NPI number?

The NPI number for Impact Wellness LLC is 1356254973. It was assigned to this organization in the NPPES registry on September 24, 2026.

Where is Impact Wellness LLC located?

Impact Wellness LLC is located at 12420 Rochford Ln, Jacksonville, FL 32225. The listed phone number is (904) 540-4722.

What is Impact Wellness LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Impact Wellness LLC was last updated on September 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.