Healthcare Provider Details

I. General information

NPI: 1174337968
Provider Name (Legal Business Name): INDEHEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 JAY ST
BROOKLYN NY
11201-3828
US

IV. Provider business mailing address

370 JAY ST
BROOKLYN NY
11201-3828
US

V. Phone/Fax

Practice location:
  • Phone: 949-220-3429
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TSIKATA APENYO
Title or Position: FOUNDER & CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 949-220-3429