NPIMap

Organization Active NPI

Indigo Legends Enterprise LLC

  • Clinic/Center
  • Raleigh, NC
National Provider Identifier
1992641740
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
INDIGO LEGENDS ENTERPRISE LLC
Practice address
4761 Queen Pierrette St
Raleigh, NC 27610-8706
Phone
(336) 268-5127
NPI assigned
Apr 24, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Authorized official

Name
Ms. Latoya Shena Wilson, LCSW-A, LCAS-ANPI 1013704071
Title
Owner
Phone
(336) 268-5127

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Meals Provider 174200000X
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Home Health Agency 251E00000X
Community/Behavioral Health Agency 251S00000X
Foster Care Agency 253J00000X
In Home Supportive Care Agency 253Z00000X
Clinic/Center 261Q00000X Primary
Adult Day Care Clinic/Center 261QA0600X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Rehabilitation Clinic/Center 261QR0400X
Assisted Living Facility 310400000X
Durable Medical Equipment & Medical Supplies 332B00000X
Non-emergency Medical Transport (VAN) 343900000X
Transportation Broker 347E00000X

Addresses

Primary practice location

4761 Queen Pierrette St
Raleigh, NC 27610-8706

Mailing address

4761 Queen Pierrette St
Raleigh, NC 27610-8706
Phone (336) 268-5127

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1776988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1992641740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4761 QUEEN PIERRETTE ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276108706",
            "telephone_number": "336-268-5127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4761 QUEEN PIERRETTE ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276108706",
            "telephone_number": "336-268-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIGO LEGENDS ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-24",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LATOYA",
        "authorized_official_middle_name": "SHENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-268-5127",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-A, LCAS-A"
    },
    "taxonomies": [
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.