Healthcare Provider Details

I. General information

NPI: 1629986831
Provider Name (Legal Business Name): INDEPENDENCE BY DESIGN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8429 EVERETT WAY UNIT E
ARVADA CO
80005-2384
US

IV. Provider business mailing address

8429 EVERETT WAY UNIT E
ARVADA CO
80005-2384
US

V. Phone/Fax

Practice location:
  • Phone: 720-988-3445
  • Fax:
Mailing address:
  • Phone: 720-988-3445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MELLISA ANDREA UMPHENOUR
Title or Position: OWNER
Credential:
Phone: 720-988-3445