# INDEPENDENT

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1922428036
- **Authorized official:** ELVIS MBUNYA (L.P.N)
- **Authorized official phone:** (216) 313-0897

## Contact information

- **Practice address:** 6406 BUSCH BLVD APT 461, COLUMBUS, OH 43229-1853
- **Practice address phone:** (216) 313-0897
- **Mailing address:** 6406 BUSCH BLVD APT 461, COLUMBUS, OH 43229-1853

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | PN.155289-M-IV | OH | Yes |

## Other

- **Enumeration date:** 04/16/2014
- **Last updated:** 04/16/2014