Independent Service Provider, LLC

Primary specialty

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

Legal business name

INDEPENDENT SERVICE PROVIDER, LLC

Practice address

3544 N Progress Ave Ste 205
Harrisburg, PA 17110-9638

Phone

(717) 882-7892

NPI assigned

Sep 7, 2021

Organization subpart

No

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

Authorized official

Name

Tilak Niroula

Title

Director

Phone

(717) 882-7892

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1740959535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3544 N PROGRESS AVE STE 205",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171109638",
            "telephone_number": "717-882-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3544 N PROGRESS AVE STE 205",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171109638",
            "telephone_number": "717-882-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT SERVICE PROVIDER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-07",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A",
        "authorized_official_last_name": "NIROULA",
        "authorized_official_first_name": "TILAK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "717-882-7892"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "insepr.com",
            "affiliation": "N",
            "endpointDescription": "domain",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3544 N Progress Ave Ste 205",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171109638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Harrisburg, PA
• Providers in Harrisburg, PA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.