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INDIE LAINE LEARNING CO LLC

Developmental Disabilities

An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).

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Contact Information

INDIE LAINE LEARNING CO LLC
5210 N CENTRAL AVE STE 101
PHOENIX, AZ  85012-1489
 Phone: 623-295-1109
 Fax:
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Developmental Disabilities

 261QD1600X
 

Behavior Analyst

 103K00000X
 

Occupational Therapist

 225X00000X 67 Occupational Therapist in Private Practice
 

Physical Therapist

 225100000X 65 Physical Therapist in Private Practice
 

Speech-Language Pathologist

 235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for INDIE LAINE LEARNING CO LLC

NPI Number 1073297099
LBN Legal business name INDIE LAINE LEARNING CO LLC
Authorized official JESSICA COSTA - (DIRECTOR OF THERAPY & CONSULTATION)
Entity Organization
Organization subpart 1 No
Enumeration date 06/12/2023
Last updated 10/01/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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