Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Impact Wellness LLC

Organization Community/Behavioral Health Agency · NPI 1356254973

Impact Wellness LLC is a Community/Behavioral Health Agency in Jacksonville, Florida. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12420 Rochford Ln
Jacksonville, FL 32225-4611
Phone: (904) 540-4722
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X

Record details

NPI number1356254973
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Gilley — President Owner · (904) 540-4722
NPI enumeratedSeptember 24, 2026
Last updated in NPPESSeptember 24, 2026
Certification dateSeptember 24, 2026
Mailing address1005 Southern Hills Dr, Orange Park, FL 32065-2652

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