Provider Demographics
NPI:1700467370
Name:INDEPENDENT BY DESIGN LLC
Entity Type:Organization
Organization Name:INDEPENDENT BY DESIGN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:DELABIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-416-4675
Mailing Address - Street 1:1338 W SEASCAPE DR
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5633
Mailing Address - Country:US
Mailing Address - Phone:480-416-4675
Mailing Address - Fax:877-598-9763
Practice Address - Street 1:1338 W SEASCAPE DR
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5633
Practice Address - Country:US
Practice Address - Phone:480-416-4675
Practice Address - Fax:877-598-9763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty