Independance Modifications Inc

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

20529716 Issued in MN

Legal business name

INDEPENDANCE MODIFICATIONS INC

Practice address

24819 Lever St NE
Isanti, MN 55040-4648

Phone

(651) 755-4459

Fax

(763) 444-6851

NPI assigned

Nov 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brent Ryan Kelsey

Title

President

Phone

(651) 755-4459

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114099165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24819 LEVER ST NE",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "550404648",
            "telephone_number": "651-755-4459",
            "fax_number": "763-444-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24819 LEVER ST NE",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "550404648",
            "telephone_number": "651-755-4459",
            "fax_number": "763-444-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDANCE MODIFICATIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELSEY",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-755-4459",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "MN",
            "license": "20529716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lowell B Hansen
• Hearswell, LLC
• Heartland Accessibility Services
• Melinda Elizabeth Hix-Demulling, LPCC
• Hope Works Counseling
• Isanti Chiropractic Clinic, PA
• Isanti Family Dental, P.L.L.C.
• J&K Comfort Home
• J&K Comfort Home
• J&K Comfort Home (J&K Comfort Homes)

• Home Modifications Contractor in Isanti, MN
• Providers in Isanti, MN by specialty
• Home Modifications Contractor in Minnesota

• 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.