Organization · Type 2 NPI

Independence Care Community Inc

Skilled Nursing Facility · Fostoria, OH

NPI number 1689673295 Active

Practice location

1000 Independence Rd
Fostoria, OH 44830

Call (419) 435-8505 Map

Fax (419) 435-0829

Mailing address

1000 Independence Rd.
Fostoria, OH 44830

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	1951 (OH)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

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NPI record

NPI: 1689673295
Entity type: Organization (Type 2)
Issued: Jul 15, 2005
Last updated: Jan 29, 2008
Status: Active
Subpart: Yes of Independence Care Community Inc dba Independence House

Other names

<unavail>
Independence House · doing business as

Authorized official

Mrs. Bridgett M Gamby-Mundy
Administrator
(419) 435-8505

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1689673295

Independence Care Community Inc's National Provider Identifier is 1689673295, issued on Jul 15, 2005. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Fostoria, OH. The record was last updated on Jan 29, 2008.