Provider Demographics
NPI:1518132190
Name:INDEPENDENCE AT HOME, INC.
Entity Type:Organization
Organization Name:INDEPENDENCE AT HOME, INC.
Other - Org Name:RIGHT AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:MAZONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-377-2400
Mailing Address - Street 1:5301 OFFICE PARK DR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0677
Mailing Address - Country:US
Mailing Address - Phone:661-377-2400
Mailing Address - Fax:661-377-2401
Practice Address - Street 1:5301 OFFICE PARK DR
Practice Address - Street 2:SUITE 410
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0677
Practice Address - Country:US
Practice Address - Phone:661-377-2400
Practice Address - Fax:661-377-2401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health