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INDIGO WELLNESS NPI 1871158089


NPI Information

NPI: 1871158089
Provider Name: INDIGO WELLNESS

Doing Business As: INDIGO WELLNESS CENTER

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
4309 SNEAD DR
LAS VEGAS, NV
ZIP 89107
Phone: (702) 913-3663
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INDIGO WELLNESS is a mental health (including community mental health center) clinic center in Las Vegas, NV. INDIGO WELLNESS NPI is 1871158089. The provider is registered as an organization entity type.
The provider Is Doing Business As Indigo Wellness Center.

The provider's business location address is:

4309 SNEAD DR
LAS VEGAS, NV
ZIP 89107-070
Phone: (702) 913-3663

The provider's authorized official is James Carter .
The authorized official title is Owner and has the following contact phone number (702) 913-3663.

The enumeration date for this NPI number is 5/2/2019 and was last updated on 7/12/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
106012620170MEDICAIDNEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.