Organization
INDIGO LIGHT HEALTH, INC.
Active
Other names
Indigo Light Support & Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
DAVIDA BOSTIC (PRESIDENT)
(786) 641-9987
Entity
Organization
Contact information
Practice address
1113 VILLA LN, BOYNTON BEACH, FL 33435-8924
(786) 641-9987
Mailing address
2774 N COBB PKWY STE 109-329, KENNESAW, GA 30152-3469
(786) 641-9987
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
163WA2000X
Administrator Registered Nurse
—
—
163WH0200X
Home Health Registered Nurse
—
—
163WN1003X
Nutrition Support Registered Nurse
—
—
171400000X
Health & Wellness Coach
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
332U00000X
Home Delivered Meals
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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