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General NPI Number Information
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NPI Number | 1417655473
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Entity Type | Organization
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Legal Business Name | INDEPENDENT HEALTHCARE 2.0
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 11806 RUTLAND AVE
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City | CLEVELAND
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State | OH
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Zip | 44108-1538
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Country | US
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Telephone | 216-301-6751
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Fax |
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Provider Business Mailing Address
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Address Line | P.O BOX 654444
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City | CLEVELAND
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State | OH
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Zip | 44105
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Country | US
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Telephone | 216-301-6751
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JETTON R FREEMAN
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Credential |
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Telephone | 216-301-6751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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