Provider Demographics
NPI:1013754001
Name:RAD INDEPENDENCE
Entity type:Organization
Organization Name:RAD INDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BARNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-203-2479
Mailing Address - Street 1:41580 WHISPERING PINES DR
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-9337
Mailing Address - Country:US
Mailing Address - Phone:406-203-2479
Mailing Address - Fax:
Practice Address - Street 1:41580 WHISPERING PINES DR
Practice Address - Street 2:
Practice Address - City:RONAN
Practice Address - State:MT
Practice Address - Zip Code:59864-9337
Practice Address - Country:US
Practice Address - Phone:406-203-2479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities