Organization
INDEPENDENCE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE ELAINE MOORE LSW (ADMINISTRATOR)
(208) 524-0881
Entity
Organization
Contact information
Practice address
1230 N SKYLINE DR STE A, IDAHO FALLS, ID 83402-1769
(208) 524-0881
(208) 524-0886
Mailing address
1230 N SKYLINE DR STE A, IDAHO FALLS, ID 83402-1769
(208) 524-0881
(208) 524-0886
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
ID
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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