Provider Demographics
NPI:1205195708
Name:INDEPENDENT YOU, LLC
Entity Type:Organization
Organization Name:INDEPENDENT YOU, LLC
Other - Org Name:INDEPENDENT YOU, SENIOR SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:CROSSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-999-3006
Mailing Address - Street 1:11606 TEN PENNY DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-1110
Mailing Address - Country:US
Mailing Address - Phone:703-999-3006
Mailing Address - Fax:
Practice Address - Street 1:11606 TEN PENNY DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX STATION
Practice Address - State:VA
Practice Address - Zip Code:22039-1110
Practice Address - Country:US
Practice Address - Phone:703-999-3006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care