OrganizationIndependence Human Services, Inc.Community/Behavioral HealthAgenciesPractice Address3722 Benson Dr Ste 101, Raleigh, NC 27609-7321(919) 930-5749PECOS EnrollmentBased on the most recent information from CMS, provider Independence Human Services, Inc. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1043453939Provider TypeOrganizationFull NameIndependence Human Services, Inc.SubpartNoEnumeration Date4/8/2009Last Updated4/8/2009Contact InformationPractice LocationPractice Address3722 Benson Dr Ste 101, Raleigh, NC 27609-7321Phone(919) 930-5749Fax(919) 882-1277Mailing LocationMailing Address3722 Benson Dr Ste 101, Raleigh, NC 27609-7321Phone(919) 930-5749Fax(919) 882-1277Authorized OfficialNameBlackburn, Charles F. (Managing Partner)Phone(919) 830-5749Provider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted IssuerCode251B00000XDescriptionCase ManagementAgenciesLicenseUnlisted IssuerNorth CarolinaCode251S00000XDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted IssuerNorth Carolina