NPI 1518081223

Independence, INC.

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Idaho Falls, ID

Practice location

Address: 1230 N Skyline Dr STE. a, Idaho Falls, ID 83402-1720
Phone: (208) 524-0881
Fax: (208) 524-0886
Mailing address: 1230 N Skyline STE. a, Idaho Falls, ID 83402

Authorised official

Name: Diane Elaine Moore
Title: Administrator
Phone: (208) 524-0881

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Idaho →

Registry record

NPI: 1518081223
Entity type: Organization
NPI issued: 19 Mar 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.