Provider Demographics
NPI:1457788127
Name:INDEPENDENT OPPORTUNITIES,LLC
Entity Type:Organization
Organization Name:INDEPENDENT OPPORTUNITIES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MONPAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-265-2014
Mailing Address - Street 1:111 S JEFFERSON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-2665
Mailing Address - Country:US
Mailing Address - Phone:307-265-2014
Mailing Address - Fax:307-265-6696
Practice Address - Street 1:111 S JEFFERSON ST STE 100
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-2665
Practice Address - Country:US
Practice Address - Phone:307-265-2014
Practice Address - Fax:307-265-6696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYCOTA-837224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY121674100Medicaid