INDIGO DIAGNOSTICS LLC; NPI #1043763972

Contact Information

INDIGO DIAGNOSTICS LLC

HC 75 BOX 1198
RUTHERON, NM 87551-9725

Phone: 505-699-5315
Fax: 575-588-0199
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Cognitive & Behavioral	103TB0200X	62	Psychologist, Clinical
Case Management	251B00000X
Day Training, Developmentally Disabled Services	251C00000X
Early Intervention Provider Agency	252Y00000X
Intellectual & Developmental Disabilities	103TM1800X	62	Psychologist, Clinical
Local Education Agency (LEA)	251300000X

Indicates primary specialty

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NPI Profile & details for INDIGO DIAGNOSTICS LLC

NPI # 1043763972

LBN Legal business name INDIGO DIAGNOSTICS LLC

Authorized official MARIANA ULIBARRI HORAN - (PSYCHO EDUCATIONAL DIAGNOSTICIAN)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/27/2016

Last updated 07/27/2016 - About 10 years ago

Identifiers

License #

350792

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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