Healthcare Provider Details

I. General information

NPI: 1013848688
Provider Name (Legal Business Name): INDEPENDENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 SANDBURG DR
LITHOPOLIS OH
43136-7514
US

IV. Provider business mailing address

59 SANDBURG DR
LITHOPOLIS OH
43136-7514
US

V. Phone/Fax

Practice location:
  • Phone: 380-209-8040
  • Fax:
Mailing address:
  • Phone: 380-209-8040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LEAIH HAIRSTON
Title or Position: OWNER
Credential: LPN
Phone: 380-209-8040