| Independence, Inc. | |
|
1230 N Skyline Dr Ste. A Idaho Falls ID 83402-1720 | |
| (208) 524-0881 | |
| (208) 524-0886 |
| Full Name | Independence, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1230 N Skyline Dr, Idaho Falls, Idaho |
| Authorized Official Name and Position | Diane Elaine Moore (ADMINISTRATOR) |
| Authorized Official Contact | 2085240881 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence, Inc. 1230 N Skyline Dr Ste. A Idaho Falls ID 83402-1720 Ph: (208) 524-0881 | Independence, Inc. 1230 N Skyline Dr Ste. A Idaho Falls ID 83402-1720 Ph: (208) 524-0881 |
| NPI Number | 1013031707 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013031707 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Idaho) | Primary |
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