Indigo Supportive Services LLC.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

INDIGO SUPPORTIVE SERVICES LLC.

Practice address

930 S. 4TH St, Ste 209 #3446
Las Vegas, NV 89101

Phone

(313) 656-8824

NPI assigned

Jun 17, 2024

Organization subpart

No

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

Authorized official

Name

Claritta Waller

Title

Owner /Operator

Phone

(313) 656-8824

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1477396356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 S. 4TH ST, STE 209 #3446",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89101",
            "telephone_number": "313-656-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S. 4TH ST, STE 209 #3446",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89101",
            "telephone_number": "313-656-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO SUPPORTIVE SERVICES LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "CLARITTA",
        "authorized_official_title_or_position": "OWNER /OPERATOR",
        "authorized_official_telephone_number": "313-656-8824"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Indian Springs Community Services
• Indiana Signal Health Receivable Management
• Indigo Pharmaceutical LLC
• Indigo Wellness
• Indigo-Bane LLC
• Individual
• Individualized Internal Medicine
• Individualized Mindful Solutions LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.