MEDICARE: INDEPENDENCE PATH SOLUTIONS LLC

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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1619806411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDEPENDENCE PATH SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	57 PINE POINT CT
Second Line	:
City	:	DALLAS
State	:	GA
Zip	:	30157-4747
Country	:	US
Telephone Number	:	770-527-9096
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 PINE POINT CT
Second Line	:
City	:	DALLAS
State	:	GA
Zip	:	30157-4747
Country	:	US
Telephone Number	:	770-527-9096
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATASHA YVONNE CAMERON
Credential	:
Telephone Number	:	770-527-9096

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “INDEPENDENCE PATH SOLUTIONS LLC ” Practice Location

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