Provider Demographics
NPI:1366563298
Name:INDEPENDENCE UNLIMITED INC.
Entity type:Organization
Organization Name:INDEPENDENCE UNLIMITED INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGETT
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CANTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-987-8123
Mailing Address - Street 1:460 LOGAN ST S
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43748-9651
Mailing Address - Country:US
Mailing Address - Phone:740-987-8123
Mailing Address - Fax:740-987-8393
Practice Address - Street 1:460 LOGAN ST S
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:OH
Practice Address - Zip Code:43748-9651
Practice Address - Country:US
Practice Address - Phone:740-987-8123
Practice Address - Fax:740-987-8393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2301048251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2301048OtherODMRDD PROVIDER NUMBER
OH2471909Medicaid