# MAKE SUPPORTIVE LIVING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MAKE SUPPORTIVE LIVING, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1346496957
- **Legal business name:** MAKE SUPPORTIVE LIVING, LLC
- **Authorized official:** MS. TAMARA NICOLE MIXON HOME CARE PROVIDER (PRESIDENT/CEO)
- **Authorized official phone:** (317) 724-8778

## Contact information

- **Practice address:** 1639 N PARK AVE, INDIANAPOLIS, IN 46202-1720
- **Practice address phone:** (317) 724-8778
- **Mailing address:** P.O BOX 88492, INDIANAPOLIS, IN 46208-0492
- **Mailing address phone:** (317) 724-8778

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | IN | Yes |

## Other

- **Enumeration date:** 08/14/2008
- **Last updated:** 08/14/2008