Organization
INDEPENDENT COMMUNITY-BASED SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA SEALEY (CHIEF EXECUTIVE OFFICER)
(910) 628-5923
Entity
Organization
Contact information
Practice address
107 N MORRO ST., FAIRMONT, NC 28340
(910) 628-5923
(910) 628-0444
Mailing address
1937 WARD STORE RD, FAIRMONT, NC 28340-6451
(910) 628-5923
(910) 628-0444
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/01/2009
Last updated
02/14/2012
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