Independence, Inc.
NPI #1518081223 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1518081223
- Entity Type
- Organization
- Organization Name
- Independence, Inc.
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Mar 19, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1230 N SKYLINE DR
- Address 2
- STE. A
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83402-1720
- Phone
- (208) 524-0881
Authorized Official
- Name
- MRS. DIANE ELAINE MOORE, LSW
- Title
- ADMINISTRATOR
- Phone
- (208) 524-0881
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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