Provider Demographics
NPI:1619281920
Name:INDEPENDENTLY MOVING, LLC
Entity Type:Organization
Organization Name:INDEPENDENTLY MOVING, LLC
Other - Org Name:INDEPENDENTLY MOVING. LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SAIOP/TEAM LEADER
Authorized Official - Prefix:MISS
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:EARLE
Authorized Official - Last Name:WILLIAMS-CADICHON
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS-P
Authorized Official - Phone:919-605-7909
Mailing Address - Street 1:1220 UNIVERSITY CT APT 1
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-4657
Mailing Address - Country:US
Mailing Address - Phone:919-605-7909
Mailing Address - Fax:
Practice Address - Street 1:1220 UNIVERSITY CT APT 1
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-4657
Practice Address - Country:US
Practice Address - Phone:919-605-7909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2495251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health