Independence Center
LBN: Independence Center
Independence Center is an health care organization with primary practice located at 4219 Laclede Ave Suite B, Saint Louis MO 63108-2814. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Allopathic & Osteopathic Physicians / Psychiatry is the primary health care specialty.
Independence Center can be contacted via phone (314) 286-4545, or through Holmes, Patricia via phone (314) 880-5415.
Contact Information
Primary practice address
4219 Laclede Ave Suite B
Saint Louis MO 63108-2814
Phone: (314) 286-4545
Fax: (314) 286-4542
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | ||
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X |
Profile Details
| NPI number | 1174668289 |
|---|---|
| LBN Legal business name | Independence Center |
| DBA Doing business as | Independence Center |
| Authorized official | Holmes, Patricia |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 20th, 2007 |
| Last updated | Jun 27th, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174668289 | NPPES |
| Missouri | MEDICAID | 503350506 | |
| Missouri | MEDICAID | 560003943 |
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