Provider Demographics
NPI:1619661584
Name:INDLOVU, LLC
Entity Type:Organization
Organization Name:INDLOVU, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIERSTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-306-0736
Mailing Address - Street 1:106 BLACK HORSE ALY
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3121
Mailing Address - Country:US
Mailing Address - Phone:610-306-0736
Mailing Address - Fax:
Practice Address - Street 1:255 S 17TH ST FL 9
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6209
Practice Address - Country:US
Practice Address - Phone:610-306-0736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty