Make Supportive Living, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MAKE SUPPORTIVE LIVING, LLC

Practice address

1639 N Park Ave
Indianapolis, IN 46202-1720

Phone

(317) 724-8778

NPI assigned

Aug 14, 2008

Organization subpart

Yes

Parent organization

MAKE SUPPORTIVE LIVING, LLCAs reported in NPPES

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

Authorized official

Name

Ms. Tamara Nicole Mixon, HOME CARE PROVIDER

Title

President/Ceo

Phone

(317) 724-8778

Specialties & licenses 1

Addresses

Part of

Make Supportive Living LLC

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

{
    "created_epoch": "1218672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1346496957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O BOX 88492",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462080492",
            "telephone_number": "317-724-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 N PARK AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021720",
            "telephone_number": "317-724-8778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAKE SUPPORTIVE LIVING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAKE SUPPORTIVE LIVING, LLC",
        "enumeration_date": "2008-08-14",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "MIXON",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "317-724-8778",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "HOME CARE PROVIDER"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abel Abiodun Makanjuola
• Katelyn G Makar, MD
• Melissa Makar
• Olivia Makar, RBT
• Make It Last 4-Ever Clinical Family Services
• Yekaterina Makhovik, MA
• Jennifer Maki, NP
• Reynold Taguba Makilan
• Pratheek Makineni, MD
• Sunil Kumar Makineni

• Home Health Agency in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Home Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.