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General NPI Number Information
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NPI Number | 1871428987
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Entity Type | Organization
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Legal Business Name | INDEPENDENT HOME LLC
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Dates
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Enumeration Date | 06/17/2026
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 1615 ESPLANADE WAY
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City | YUBA CITY
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State | CA
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Zip | 95993-1010
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Country | US
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Telephone | 530-674-1129
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Fax | 530-674-1129
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Provider Business Mailing Address
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Address Line | 1615 ESPLANADE WAY
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City | YUBA CITY
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State | CA
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Zip | 95993-1010
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Country | US
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Telephone | 530-674-1129
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Fax | 530-674-1129
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Authorized Official
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Title or Position | MANAGER
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Name | AIDA DIAZ GOINES
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Credential | HOME
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Telephone | 530-635-7585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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