# INDIVIDUALIZED SUPPORT SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386970846
- **Authorized official:** RENA ARLENE BAKER (ONER)
- **Authorized official phone:** (772) 696-3189

## Contact information

- **Practice address:** 1965 42ND AVE STE 3, VERO BEACH, FL 32960-2502
- **Practice address phone:** (772) 492-9159
- **Practice address fax:** (772) 492-9147
- **Mailing address:** 234 SW STARFLOWER AVE, PORT ST LUCIE, FL 34984-4461
- **Mailing address phone:** (772) 696-3189
- **Mailing address fax:** (772) 492-9147

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 001173600 | FL | Yes |
| 251E00000X | Home Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 10/19/2009
- **Last updated:** 10/19/2009