INDEPENDENCE CENTER (NPI# 1760839260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760839260 |
| Entity Type | Organization |
| Organization Name | INDEPENDENCE CENTER |
| Practice Address |
4245 Forest Park Ave Saint Louis MO 63108-2810 |
| Practice Telephone | 3148805415 |
| Practice Fax Number | 3148805468 |
| Mailing Telephone | 3148805415 |
| Mailing Fax Number | 3148805468 |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |
| Authorized Official Name | ANGELA GRIFFARD (CFO) |
| Authorized Official Telephone | 3148805415 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619146420 | Independence Center | Community/Behavioral Health | 320 N Ash St, Waukegan, IL 60085-3985 | 2008-02-26 |
| 1699944413 | Independence Center | Case Management | 813 Indiana Ave, Waukegan, IL 60085-2612 | 2008-02-26 |
| 1881863603 | Independence Center | Case Management | 815 Indiana Ave, Waukegan, IL 60085-2612 | 2008-02-26 |
| 1235308057 | Independence Center | Case Management | 817 Indiana Ave, Waukegan, IL 60085-2612 | 2008-02-26 |
| 1427227230 | Independence Center | Case Management | 819 Indiana Ave, Waukegan, IL 60085-2612 | 2008-02-26 |
| 1336318153 | Independence Center | Case Management | 1730 Washington St, Waukegan, IL 60085-5102 | 2008-02-26 |
| 1427227248 | Independence Center | Case Management | 2835 Washington St, Waukegan, IL 60085-4839 | 2008-02-26 |
| 1972772788 | Independence Center | Case Management | 2839 Washington St, Waukegan, IL 60085-4839 | 2008-02-26 |
| 1558494286 | Independence Center | Community/Behavioral Health | 8675 Olive Blvd, Saint Louis, MO 63132-2503 | 2007-03-13 |
| 1174669006 | Independence Center | Community Based Residential Treatment Facility, Mental Illness | 2443 Prouhet Ave, Saint Louis, MO 63114-1946 | 2007-01-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | INDEPENDENCE CENTER INC | 2025 Washington St, Waukegan, IL 60085-5131 |
| Massachusetts Corporations | INDEPENDENCE CENTER LLC | 4 Clinton Square, C/o The Clinton Companies, Syracuse, NY 13202 |
| Massachusetts Corporations | INDEPENDENCE CENTER NEWCO LLC | The Clinton Exchange, 4 Clinton Square, C/o The Pyramid Companies, Syracuse, NY 13202 |
| Street Address |
4245 FOREST PARK AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63108-2810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851474 | Nigel Austen Thomas Cook | Social Worker | 4050 West Pine Blvd. Apt. 4118, St. Louis, MO 63108 | 2020-08-12 |
| 1467070011 | C2n Diagnostics, LLC | Clinical Medical Laboratory | 20 South Sarah Street, Saint Louis, MO 63108 | 2020-07-10 |
| 1609414358 | Kaylee Breitenbucher | Occupational Therapist | 4444 Forest Park Avenue, Msc 8505-94-01, St. Louis, MO 63108 | 2019-12-12 |
| 1114419546 | Activangels Home Health | Home Health | 4625 Lindell Blvd Ste 304, Saint Louis, MO 63108 | 2018-06-01 |
| 1215427349 | Heart To Heart Consolidated Home Care Service LLC | Home Health | 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108 | 2018-05-15 |
| 1447755905 | Erin Virginia Adams | Student in an Organized Health Care Education/Training Program | 4355 Maryland Ave Apt 116, Saint Louis, MO 63108 | 2018-03-27 |
| 1033621172 | Roots Healthcare and Homes | In Home Supportive Care | 4300 Enright Ave, St. Louis, MO 63108 | 2017-10-30 |
| 1336661719 | House of Destiny Adult Day Care LLC | Clinic/Center | 4507 Olive Street, St Louis, MO 63108 | 2017-07-07 |
| 1003338492 | Khin Min Thu | Social Worker | 4236 Lindell Blvd., Suite 200, St Louis, MO 63108 | 2017-07-07 |
| 1679093967 | Together We Can Home Healthcare Services LLC | Home Health | 4144 Lindell Blvd Suite 221, Saint Louis, MO 63108 | 2017-06-27 |
| Find all providers in zip 63108 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780069161 | Iqbal Psychiatry | Clinic/Center | 1015 Grupp Rd Unit 31035, Saint Louis, MO 63131-5002 | 2015-07-27 |
| 1346569324 | Golden Years Adult Day Health Care LLC | Clinic/Center | 12257 Bellefontaine Rd, Saint Louis, MO 63138-1447 | 2010-05-31 |
| 1629303565 | Lindell Psychiatric Associates, Inc | Clinic/Center | 265 Union Blvd, Suite 1120, Saint Louis, MO 63108-1200 | 2009-10-09 |
| 1942270863 | Bilingual International Assistant Services | Clinic/Center | 1329 Macklind Ave Ste 200, Saint Louis, MO 63110-1400 | 2006-01-24 |
| 1326693904 | Jesus Ligot Md LLC | Clinic/Center | 1201 Bellevue Ave, Saint Louis, MO 63117-1701 | 2019-08-09 |
| 1790346542 | Art Maines, Lcsw LLC | Clinic/Center | 1121 Olivette Executive Pkwy Ste 210, Saint Louis, MO 63132-3254 | 2019-06-24 |
| 1427529965 | James Rw Linsin Psyd LLC | Clinic/Center | 777 S New Ballas Rd Ste 129w, Saint Louis, MO 63141-8745 | 2018-12-10 |
| 1942719885 | Cathy Luebbering Msw Lcsw LLC | Clinic/Center | 2601 Sutton Blvd, Saint Louis, MO 63143-2117 | 2017-09-22 |
| 1629427042 | Queen of Peace Center | Clinic/Center | 325 N Newstead Ave, Saint Louis, MO 63108-2707 | 2016-06-07 |
| 1114374634 | Adapt of Missouri Inc. | Clinic/Center | 2301 Hampton Ave, Saint Louis, MO 63139-2908 | 2016-05-16 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63108 |
Please comment or provide details below to improve the information on INDEPENDENCE CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.