Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Support Independent Living

Organization Developmental Disabilities Clinic/Center · NPI 1306590260

Support Independent Living is a Developmental Disabilities Clinic/Center in Fort Walton Beach, Florida. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

11 Racetrack Rd NE Ste C2
Fort Walton Beach, FL 32547-1867
Phone: (850) 259-7190
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Developmental Disabilities Clinic/Center (primary) Taxonomy 261QD1600X

Record details

NPI number1306590260
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brenda Marrier — Owner · (850) 259-7190
Other names Support Independent Living
NPI enumeratedFebruary 9, 2022
Last updated in NPPESFebruary 9, 2022
Certification dateFebruary 9, 2022
Mailing address11 Racetrack Rd Ne Ste C2, Fort Walton Beach, FL 32547-1867