Provider Demographics
NPI:1801036967
Name:ELECT INDEPENDENCE LLC
Entity Type:Organization
Organization Name:ELECT INDEPENDENCE LLC
Other - Org Name:ELECT HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-753-3700
Mailing Address - Street 1:319 S MAIN ST STE F
Mailing Address - Street 2:PO BOX 204
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742-9424
Mailing Address - Country:US
Mailing Address - Phone:417-753-3700
Mailing Address - Fax:417-753-3706
Practice Address - Street 1:319 S MAIN ST
Practice Address - Street 2:SUITE F
Practice Address - City:ROGERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65742-9361
Practice Address - Country:US
Practice Address - Phone:417-753-3700
Practice Address - Fax:417-753-3706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOLC0864283253Z00000X
385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care