Provider Demographics
NPI:1073758561
Name:INDEPENDENCE HCS, INC.
Entity Type:Organization
Organization Name:INDEPENDENCE HCS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:WHITE
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-398-9111
Mailing Address - Street 1:707 MARANON LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-1309
Mailing Address - Country:US
Mailing Address - Phone:713-398-9111
Mailing Address - Fax:281-444-6328
Practice Address - Street 1:707 MARANON LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-1309
Practice Address - Country:US
Practice Address - Phone:713-398-9111
Practice Address - Fax:281-444-6328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services