Provider Demographics
NPI:1831583681
Name:4 YOUR INDEPENDENCE
Entity type:Organization
Organization Name:4 YOUR INDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:330-687-5683
Mailing Address - Street 1:885 CLEMENT ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-2914
Mailing Address - Country:US
Mailing Address - Phone:330-687-5683
Mailing Address - Fax:
Practice Address - Street 1:885 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-2914
Practice Address - Country:US
Practice Address - Phone:330-687-5683
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health