INDIE LAINE LEARNING CO LLC NPI 1073297099

NPI Information

  • NPI: 1073297099
  • Provider Name: INDIE LAINE LEARNING CO LLC
  • Classification: Clinic/Center - 261QD1600X
  • Specialization: Developmental Disabilities
  • Entity Type: Organization
  • Address: 5210 N CENTRAL AVE STE 101
    PHOENIX, AZ
    ZIP 85012
  • Phone: (623) 295-1109

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NPI Details

INDIE LAINE LEARNING CO LLC is a developmental disabilities clinic center in Phoenix, AZ. The provider is 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.). INDIE LAINE LEARNING CO LLC NPI is 1073297099. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5210 N CENTRAL AVE STE 101
PHOENIX, AZ
ZIP 85012-489
Phone: (623) 295-1109

The provider's authorized official is Jessica T Costa .
The authorized official title is Director Of Therapy & Consultation and has the following contact phone number (860) 371-4586.

The enumeration date for this NPI number is 6/12/2023 and was last updated on 10/1/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103K00000XBehavior AnalystNo
2225100000XPhysical TherapistNo
3225X00000XOccupational TherapistNo
4235Z00000XSpeech-Language PathologistNo
5261QD1600XClinic/CenterDevelopmental DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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