Provider Demographics
NPI:1821502873
Name:INDIGO HOMEHEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:INDIGO HOMEHEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JANELLA
Authorized Official - Last Name:BLAKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-528-1814
Mailing Address - Street 1:500 CRAWFORD ST APT 344
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-2190
Mailing Address - Country:US
Mailing Address - Phone:832-528-1814
Mailing Address - Fax:832-301-0825
Practice Address - Street 1:500 CRAWFORD ST APT 344
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-2190
Practice Address - Country:US
Practice Address - Phone:832-528-1814
Practice Address - Fax:281-301-0825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-29
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health