Provider Demographics
NPI:1801353826
Name:INDEPENDENCY LLC
Entity type:Organization
Organization Name:INDEPENDENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-358-7491
Mailing Address - Street 1:300 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-1604
Mailing Address - Country:US
Mailing Address - Phone:740-358-7491
Mailing Address - Fax:740-326-6162
Practice Address - Street 1:300 COOPER ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1604
Practice Address - Country:US
Practice Address - Phone:740-358-7491
Practice Address - Fax:740-326-6162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0080812Medicaid
OHNAOtherAETNA
OHNAMedicaid