Organization
INDEPENDENCE ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CONSTANCE MONIQUE GALLANT (EXECUTIVE DIRECTOR)
(508) 583-2166
Entity
Organization
Contact information
Practice address
141 MAIN ST FL 1, BROCKTON, MA 02301-4012
(508) 583-2166
(508) 583-2165
Mailing address
141 MAIN ST FL 1, BROCKTON, MA 02301-4012
(508) 583-2166
(508) 583-2165
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5800153
—
MA
Enumeration date
05/23/2007
Last updated
08/22/2020
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