Provider Demographics
NPI:1851463483
Name:INDEPENDENT OPTIONS INC
Entity Type:Organization
Organization Name:INDEPENDENT OPTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:REGNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-279-2585
Mailing Address - Street 1:PO BOX 2197
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92878
Mailing Address - Country:US
Mailing Address - Phone:951-279-2585
Mailing Address - Fax:951-279-4860
Practice Address - Street 1:1180 OLYMPIC DR STE 101
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-3393
Practice Address - Country:US
Practice Address - Phone:951-279-2585
Practice Address - Fax:951-279-4860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness