INDEV SUPPORTED LIVING LLC. NPI 1578089439

NPI Information

  • NPI: 1578089439
  • Provider Name: INDEV SUPPORTED LIVING LLC.
  • Classification: In Home Supportive Care - 253Z00000X
  • Entity Type: Organization
  • :
  • CLIA Number: 44D2232148
  • Address: 2675 UNION AVENUE EXT
    MEMPHIS, TN
    ZIP 38112
  • Phone: (901) 682-2022

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NPI Details

INDEV SUPPORTED LIVING LLC. is an in home supportive care in Memphis, TN. The provider is an In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. INDEV SUPPORTED LIVING LLC. NPI is 1578089439. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

2675 UNION AVENUE EXT
MEMPHIS, TN
ZIP 38112-401
Phone: (901) 682-2022
Fax: (901) 682-2052

The provider's authorized official is Ricardo Heros .
The authorized official title is Ceo and has the following contact phone number (901) 682-2022.

The CLIA number assigned to this NPI record is 44D2232148 - other - didd supported living age with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/22/2017 and was last updated on 3/11/2025.

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
1253Z00000XIn Home Supportive CareYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100F91MEDICAIDTENNESSEE

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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