Independent Community Services

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

INDEPENDENT COMMUNITY SERVICES

Practice address

675 Deis Dr # 201
Fairfield, OH 45014-8136

Phone

(513) 817-4888

NPI assigned

Oct 8, 2020

Organization subpart

No

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

Authorized official

Name

Miss Karissa Janay Marshall

Title

Ceo

Phone

(423) 316-0557

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1992302384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 DEIS DR # 201",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450148136",
            "telephone_number": "513-817-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 DEIS DR # 201",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450148136",
            "telephone_number": "513-817-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-08",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "KARISSA",
        "authorized_official_middle_name": "JANAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "423-316-0557",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902322027",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blaise Ileleke Bomandeke
• Ayisha Ilias, FNP-C
• Donald Kolman Imwalle, MD
• Mark David Imwalle, MD
• In Catherines Care LLC
• Jennifer Ingle, DMD
• Integrated Pain Solutions Incorporated
• International Home Care LLC
• Intra-National Pharmacy Cincinnati LLC
• MD. Wahidul Islam, MD

• Developmentally Disabled Services Day Training Agency in Fairfield, OH
• Providers in Fairfield, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.