Independence Place, Inc

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

INDEPENDENCE PLACE, INC

Practice address

2358 Nicholasville Rd Ste 180
Lexington, KY 40503-3049

Phone

(859) 266-2807

Fax

(859) 335-0627

NPI assigned

May 1, 2018

Organization subpart

No

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

Authorized official

Name

Willis Deitz

Title

Executive Director

Phone

(270) 871-5617

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525132800000",
    "number": "1255829610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2358 NICHOLASVILLE RD STE 180",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033049",
            "telephone_number": "859-266-2807",
            "fax_number": "859-335-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2358 NICHOLASVILLE RD STE 180",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033049",
            "telephone_number": "859-266-2807",
            "fax_number": "859-335-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE PLACE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A",
        "authorized_official_last_name": "DEITZ",
        "authorized_official_first_name": "WILLIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "270-871-5617"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.