Independent Disability Services

NPI #1093926099 in Little Falls, Minnesota

Provider Information

NPI Number: 1093926099
Entity Type: Organization
Organization Name: Independent Disability Services
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: May 24, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1201 5TH AVE SE
City: Little Falls
State: Minnesota
ZIP Code: 56345-3342
Phone: (320) 632-2674

Authorized Official

Name: TANYA MARIE DEROSIER
Title: PROGRAM MANAGER
Phone: (320) 632-2674

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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