# INDEPENDENT FOR LIFE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sharon Mc Cants
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679748743
- **Authorized official:** MS. SHARON L MC CANTS (AGANT OWNER)
- **Authorized official phone:** (513) 344-9306

## Contact information

- **Practice address:** 4301 CAPPEL DR, CINCINNATI, OH 45205-2023
- **Practice address phone:** (513) 344-9306
- **Practice address fax:** (513) 251-3522
- **Mailing address:** 4301 CAPPEL DR, CINCINNATI, OH 45205-2023
- **Mailing address phone:** (513) 344-9306
- **Mailing address fax:** (513) 251-3522

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 2429634 | OH | Yes |

## Other

- **Enumeration date:** 04/29/2008
- **Last updated:** 04/29/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2429634 | MEDICAID PIN ODJFS | OH |