Organization
INDEPENDENCE MC, LLC
Active
Other names
Jackson Creek Memory Care
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MITCHELL (SECRETARY)
(385) 988-3319
Entity
Organization
Contact information
Practice address
19400 E 40TH STREET CT S, INDEPENDENCE, MO 64057-1548
(816) 478-5689
Mailing address
262 N UNIVERSITY AVE, FARMINGTON, UT 84025-2975
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
—
Other
Enumeration date
01/10/2024
Last updated
08/21/2024
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