Organization Name: | INDEPENDENCE HOME CARE |
NPI Number: | 1235470337 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL FRASURE (MANAGING PARTNER) |
Mailing Address: | 640 S. 500 W. Bountiful |
State: | UT US |
Postal Code: | 840107210 |
Phone Number: | 8012981100 |
Fax Number: | 8012981988 |
NPI Enumeration Date: | 03/14/2013 |
NPI Last Update Date: | 05/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |