Organization
INDEPENDENCE CARE COMMUNITY INC
Active
Parent organization
INDEPENDENCE CARE COMMUNITY INC DBA INDEPENDENCE HOUSE
Other names
Independence House
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENCE CARE COMMUNITY INC DBA INDEPENDENCE HOUSE
Authorized official
MRS. BRIDGETT M GAMBY-MUNDY (ADMINISTRATOR)
(419) 435-8505
Entity
Organization
Contact information
Practice address
1000 INDEPENDENCE RD, FOSTORIA, OH 44830
(419) 435-8505
(419) 435-0829
Mailing address
1000 INDEPENDENCE RD., FOSTORIA, OH 44830
(419) 435-8505
(419) 435-0829
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1951
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0960189
—
OH
Enumeration date
07/15/2005
Last updated
01/29/2008
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