MEDICARE: YOUR INDEPENDENCE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	7706870	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982968301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR INDEPENDENCE INC

Provider Business Mailing Address
First Line	:	1557 VERNON ODOM BLVD
Second Line	:	104
City	:	AKRON
State	:	OH
Zip	:	44320-4061
Country	:	US
Telephone Number	:	866-287-4157
Fax Number	:	330-983-9494

Provider Business Practice Location Address
First Line	:	1557 VERNON ODOM BLVD
Second Line	:	104
City	:	AKRON
State	:	OH
Zip	:	44320-4061
Country	:	US
Telephone Number	:	866-287-4157
Fax Number	:	330-983-9494

Authorized Official
Title or Position	:	CEO
Name	:	MS. JESSICA K JONES
Credential	:
Telephone Number	:	866-287-4157

Provider Enumeration Date	:	06/29/2012
Last Update Date	:	01/21/2013

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Directions to “YOUR INDEPENDENCE INC ” Practice Location

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