Organization
INDEPENDENT AT HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY JOHNSON (RESIDENT AGENT)
(617) 943-9384
Entity
Organization
Contact information
Practice address
56 CHERRY ST, 3RD FLOOR, BROCKTON, MA 02301-2608
(617) 943-9384
(888) 407-5574
Mailing address
56 CHERRY ST, 3RD FLOOR, BROCKTON, MA 02301-2608
(617) 943-9384
(888) 407-5574
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/21/2012
Last updated
01/08/2014
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