INDIGO LEGENDS ENTERPRISE LLC NPI 1992641740

NPI Information

  • NPI: 1992641740
  • Provider Name: INDIGO LEGENDS ENTERPRISE LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 4761 QUEEN PIERRETTE ST
    RALEIGH, NC
    ZIP 27610
  • Phone: (336) 268-5127

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NPI Details

INDIGO LEGENDS ENTERPRISE LLC is a clinic center in Raleigh, NC. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). INDIGO LEGENDS ENTERPRISE LLC NPI is 1992641740. The provider is registered as an organization entity type.

The provider's business location address is:

4761 QUEEN PIERRETTE ST
RALEIGH, NC
ZIP 27610-706
Phone: (336) 268-5127

The provider's authorized official is Latoya Shena Wilson .
The authorized official title is Owner and has the following contact phone number (336) 268-5127.

The enumeration date for this NPI number is 4/24/2026 and was last updated on 4/24/2026.

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
1251C00000XDay Training, Developmentally Disabled ServicesNo
2251S00000XCommunity/Behavioral HealthNo
3251E00000XHome HealthNo
4251B00000XCase ManagementNo
5253Z00000XIn Home Supportive CareNo
6253J00000XFoster Care AgencyNo
7343900000XNon-emergency Medical Transport (VAN)No
8261QA0600XClinic/CenterAdult Day CareNo
9332B00000XDurable Medical Equipment & Medical SuppliesNo
10261QR0400XClinic/CenterRehabilitationNo
11347E00000XTransportation BrokerNo
12261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
13310400000XAssisted Living FacilityNo
14174200000XMealsNo
15261Q00000XClinic/CenterYes

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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