Provider Demographics
NPI:1588847396
Name:MY INDEPENDENCE, INC.
Entity Type:Organization
Organization Name:MY INDEPENDENCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARRIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-698-9240
Mailing Address - Street 1:22819 E RANGE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-2139
Mailing Address - Country:US
Mailing Address - Phone:210-698-9240
Mailing Address - Fax:210-228-0144
Practice Address - Street 1:22819 E RANGE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78255-2139
Practice Address - Country:US
Practice Address - Phone:210-698-9240
Practice Address - Fax:210-228-0144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility