DEVELOPMENTAL IMPACT, LLC (NPI# 1497389860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497389860 |
| Entity Type | Organization |
| Organization Name | DEVELOPMENTAL IMPACT, LLC |
| Practice Address |
15610 Passaie Ln Bowie MD 20716-1443 |
| Practice Telephone | 2404086167 |
| Practice Fax Number | 3012494324 |
| Mailing Telephone | 2404086167 |
| Mailing Fax Number | 3012494324 |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |
| Authorized Official Name | MRS. LAURETTA REFFELL BEARD (CEO) |
| Authorized Official Telephone | 2404086167 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251X00000X | Supports Brokerage | Agencies |
| Street Address |
15610 PASSAIE LN |
| City | BOWIE |
| State | MD |
| Zip Code | 20716-1443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407223431 | Dilys Anzikengnzem | Licensed Practical Nurse | 15610 Passaie Ln, Bowie, MD 20716-1443 | 2015-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508330903 | Stacey Katheryn Lundquist | Counselor | 3060 Michellville Rd, Suite 106, Bowie, MD 20716 | 2019-01-18 |
| 1427528819 | Nicole Rudd | Counselor | 4315 Northview Dr, Bowie, MD 20716 | 2018-11-28 |
| 1427541838 | Outreach Recovery II, LLC | Internal Medicine | 4201 Northview Dr Ste 104, Bowie, MD 20716 | 2018-06-11 |
| 1487143608 | Fatimata Koroma | Counselor | 3953 Elite St, Bowie, MD 20716 | 2018-05-02 |
| 1043739618 | Breanna Collinson | Behavior Technician | 3017 New Oak Ln., Bowie, MD 20716 | 2017-09-15 |
| 1790202000 | Sierra Williams Howell | Nurse Practitioner | 2802 Eliston Street, Bowie, MD 20716 | 2017-08-28 |
| 1487175105 | Martine Jean | Technician | 15911 Pointer Ridge Rd, Bowie, MD 20716 | 2017-07-03 |
| 1902254493 | Olachi Enwerem | Licensed Practical Nurse | 16206 Audubon Lane, Bowie, MD 20716 | 2016-05-25 |
| 1780039230 | Debra Lachaune Garris | Specialist | 3042 Mitchiville Road, Bowie, MD 20716 | 2016-05-03 |
| 1750782553 | Medical Trasportation Systems LLC | Non-emergency Medical Transport (VAN) | 16036 Elegant Ave, Bowie, MD 20716 | 2014-09-11 |
| Find all providers in zip 20716 | ||||
| Taxonomy Code | 251X00000X |
| Grouping | Agencies |
| Classification | Supports Brokerage |
| A provider of service/function that assists participating individuals to make informed decisions about what will work best for them is consistent with their needs and reflects their individual circumstances. Serving as the agent of the individual, the service is available to assist in identifying immediate and long-term needs, developing options to meet those needs and accessing identified supports and services and may include assistance with recruiting, screening, hiring, and training in-home support providers. A family or person-centered planning approach is used. Supports Brokerage offers practical skills training to enable families and individuals to remain independent. Examples of skills training include providing information on recruiting and hiring personal care workers, managing personal care workers and providing information on effective communication and problem solving. The service/function provides sufficient information to assure that individuals understand the responsibilities involved with self-direction and assist in the development of an effective back-up and emergency plan. Plans may elect to fulfill the requirement of this service/function using a self-directed case manager or creating a distinct service. The Supports Brokerage documents the need for assistive services, planning for and documenting the use of excess funds and locating and maintaining services. |
| Notes: Source: CMS Independence Plus Waiver template. [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093325136 | Physicians Trust Claims Services | Supports Brokerage | 15938 Alameda Dr, Bowie, MD 20716-1331 | 2020-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1770142077 | Digital Network Group, LLC | Supports Brokerage | 1801 Mccormick Dr Ste 350, Largo, MD 20774-5468 | 2019-06-10 |
| 1033617725 | Morning Star Group Services Inc | Supports Brokerage | 8629 Liberty Rd Ste E, Randallstown, MD 21133-4713 | 2018-01-26 |
| 1629506241 | True Motivation Works LLC | Supports Brokerage | 9185 Bourbon Street, Suite N, Laurel, MD 20723 | 2017-05-26 |
| 1114302916 | Healthcare and Informatics Innovation Network | Supports Brokerage | 11141 Georgia Ave Apt 515, Wheaton, MD 20902-7680 | 2015-07-22 |
| 1164816823 | Golda-amit Incorporated | Supports Brokerage | 11919 Tarragon Rd, Apt A, Reisterstown, MD 21136 | 2015-03-20 |
| 1346550506 | Administrative Services, Inc. | Supports Brokerage | 7101 Wisconsin Avenue, Suite 1400, Bethesda, MD 20814-4864 | 2010-10-20 |
| 1902370026 | Focus Point Solutions LLC | Supports Brokerage | 803 N Salisbury Blvd Ste 2200, Salisbury, MD 21801-3657 | 2019-01-11 |
| 1225546526 | Cynthia Truitt | Supports Brokerage | 12641 Blueberry Rd, Whaleyville, MD 21872-2013 | 2018-01-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.