# INDEPENDENCE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518081223
- **Authorized official:** MRS. DIANE ELAINE MOORE LSW (ADMINISTRATOR)
- **Authorized official phone:** (208) 524-0881

## Contact information

- **Practice address:** 1230 N SKYLINE DR, STE. A, IDAHO FALLS, ID 83402-1720
- **Practice address phone:** (208) 524-0881
- **Practice address fax:** (208) 524-0886
- **Mailing address:** 1230 N SKYLINE, STE. A, IDAHO FALLS, ID 83402
- **Mailing address phone:** (208) 524-0881
- **Mailing address fax:** (208) 524-0886

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | ID | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 08/22/2020