| NPI | 1912178070 |
|---|---|
| Former Legal Business Name | & INDEPENDENT GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | STEPHAINE EVE FIELDS Owner 769-233-3870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Additional Taxonomies | 347C00000X Private Vehicle |
| 385HR2050X Respite Care, Respite Care Camp | |
| 310400000X Assisted Living Facility | |
| 315D00000X Hospice, Inpatient | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2008-04-08 |