| Indie Laine Learning Co Llc | |
|
5210 N Central Ave Ste 101 Phoenix AZ 85012-1489 | |
| (623) 295-1109 | |
| Not Available |
| Full Name | Indie Laine Learning Co Llc |
|---|---|
| Speciality | Clinic/center - Developmental Disabilities |
| Location | 5210 N Central Ave Ste 101, Phoenix, Arizona |
| Authorized Official Name and Position | Jessica T Costa (DIRECTOR OF THERAPY & CONSULTATION) |
| Authorized Official Contact | 8603714586 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indie Laine Learning Co Llc 7025 S 42nd Ave Phoenix AZ 85041-3508 Ph: (860) 371-4586 | Indie Laine Learning Co Llc 5210 N Central Ave Ste 101 Phoenix AZ 85012-1489 Ph: (623) 295-1109 |
| NPI Number | 1073297099 |
|---|---|
| Provider Enumeration Date | 06/12/2023 |
| Last Update Date | 10/01/2024 |
| Certification Date | 10/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073297099 | NPI | - | NPPES |
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