Independence Coaching, L.L.C.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

INDEPENDENCE COACHING, L.L.C.

Practice address

1345 E Butler Dr
Phoenix, AZ 85020-3824

Phone

(602) 524-0583

Fax

(602) 297-6758

NPI assigned

May 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Vern Johnson, BSW

Title

President

Phone

(602) 524-0583

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073726162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 E BUTLER DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850203824",
            "telephone_number": "602-524-0583",
            "fax_number": "602-297-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 E BUTLER DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850203824",
            "telephone_number": "602-524-0583",
            "fax_number": "602-297-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE COACHING, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VERN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-524-0583",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSW"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.