Indigo Center for Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

INDIGO CENTER FOR SENIOR LIVING LLC

Practice address

113 W Chipola Ave
Deland, FL 32720-7512

Phone

(386) 738-2700

Fax

(386) 822-9296

NPI assigned

Mar 30, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mordechai Weisz

Title

Ceo

Phone

(347) 631-4068

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Woodland Towers Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1043950801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W CHIPOLA AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327207512",
            "telephone_number": "386-738-2700",
            "fax_number": "386-822-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W CHIPOLA AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327207512",
            "telephone_number": "386-738-2700",
            "fax_number": "386-822-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO CENTER FOR SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "WEISZ",
        "authorized_official_first_name": "MORDECHAI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-631-4068"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "AL7143",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113963100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodland Towers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Woodland Towers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Hunt II, R.PH.
• Lisa G Huser, RN
• Richard H Huster, MD
• Sharon Sue Hyles, LMFT, LMHC
• Roselany Ilovares, DPT
• Ashley Ingram
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• Assisted Living Facility in Deland, FL
• Providers in Deland, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.