Individualized Support Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

001173600 Issued in FL

Legal business name

INDIVIDUALIZED SUPPORT SERVICES LLC

Practice address

1965 42ND Ave Ste 3
Vero Beach, FL 32960-2502

Phone

(772) 492-9159

Fax

(772) 492-9147

NPI assigned

Oct 19, 2009

Organization subpart

No

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

Authorized official

Name

Rena Arlene Baker

Title

Oner

Phone

(772) 696-3189

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255910400000",
    "number": "1386970846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 SW STARFLOWER AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349844461",
            "telephone_number": "772-696-3189",
            "fax_number": "772-492-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1965 42ND AVE STE 3",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329602502",
            "telephone_number": "772-492-9159",
            "fax_number": "772-492-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIVIDUALIZED SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-19",
        "last_updated": "2009-10-19",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "RENA",
        "authorized_official_middle_name": "ARLENE",
        "authorized_official_title_or_position": "ONER",
        "authorized_official_telephone_number": "772-696-3189"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "001173600",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER (HCBS) AND (FSL)",
            "identifier": "001173600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Indian River Surgery Center LTD
• Indian River Surgery Center, LTD.
• Indian River Surgical Associates, LLC
• Indian River Surgical Service Corp.
• Indian River Urology Associates PA
• Infusion Services of the Treasure Coast Inc
• Katherine Ingerto, DPT
• Corey Deangelo Ingram
• Catee Ingwersen
• Rebecca Inman, LMHC

• Home Health Agency in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2009; 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.