Independent Homes, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

139901001 Issued in VA

Legal business name

INDEPENDENT HOMES, INC

Practice address

1816 Arch St
Petersburg, VA 23805-1618

Phone

(804) 721-1720

Fax

(804) 214-2177

NPI assigned

Dec 4, 2011

Organization subpart

No

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

Authorized official

Name

Pascal Thebaud

Title

Executive Director

Phone

(804) 721-1720

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1322956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322956800000",
    "number": "1285902320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3163",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238053163",
            "telephone_number": "804-721-1720",
            "fax_number": "804-214-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 ARCH ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238051618",
            "telephone_number": "804-721-1720",
            "fax_number": "804-214-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT HOMES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-04",
        "last_updated": "2011-12-04",
        "status": "A",
        "authorized_official_last_name": "THEBAUD",
        "authorized_official_first_name": "PASCAL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-721-1720"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "139901001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Hunt
• Aun Hussain, PA-C
• Iep Partners, LLC
• Impacting Futures Community Services
• Independent Family Services, LLC
• Ink Family Services, LLC
• Integrated Life Services LLC
• Intensacare Home Health Services, LLC
• Interfaith Adult Day Care, Inc.
• Irish Fleet Inc.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2011; 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.