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INDEPENDENCE HALL OPERATOR, LLC
NPI 1689382954
Assisted Living Facility in Wilton Manors, FL

Active since November 07, 2022CLIA 10D2281637 · Waiver
1639 NE 26TH ST, WILTON MANORS, FL 33305(954) 563-6232 Get Directions Write a Review

NPPES record last updated: November 7, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Independence Hall Operator, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INDEPENDENCE HALL OPERATOR, LLC (NPI 1689382954) is a healthcare organization registered as an assisted living facility in Wilton Manors, Florida and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through May 9, 2027 and lists Thomas Michael Rabold, Managing Partner, as its authorized official.

NPPES Registry Identity

NPI1689382954
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameINDEPENDENCE HALL OPERATOR, LLC
Location Address1639 NE 26TH STWilton Manors, FL 33305-1410
Mailing Address215 N New River Dr E Apt 1600Fort Lauderdale, FL 33301-1091 · (954) 496-0387
Phone(954) 563-6232
Organization SubpartNo
Authorized OfficialThomas Michael RaboldManaging Partner · (954) 496-0387
Enumeration DateNovember 7, 2022
NPPES CertifiedNovember 7, 2022
✔ NPI 1689382954 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
1639 NE 26TH ST, Wilton Manors, FL 33305
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2281637

Independence Hall · Wilton Manors, FL
Active · expires May 9, 2027
CLIA Number10D2281637
Laboratory TypeAssisted Living Facility
Certificate Effective DateMay 10, 2025
Certificate Expiration DateMay 9, 2027
Laboratory DirectorSonja Jorgensen
Laboratory Phone(954) 563-6232
Laboratory LocationIndependence Hall1639 NE 26th Street, Wilton Manors, FL 33305
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STELLAR THERAPY SERVICES LLC
Physical Therapist
1639 NE 26TH ST
WILTON MANORS, FL 33305
Broward County (781) 866-1943
MARRINSON GROUP, INC
Assisted Living Facility
1639 NE 26TH ST
WILTON MANORS, FL 33305
Broward County (954) 566-8353
1639 OPCO, LLC
Assisted Living Facility
1639 NE 26TH ST
WILTON MANORS, FL 33305
Broward County (847) 917-8337

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Independence Hall Operator, LLC's NPI number?

The NPI number for Independence Hall Operator, LLC is 1689382954. It was assigned to this organization in the NPPES registry on November 7, 2022.

Where is Independence Hall Operator, LLC located?

Independence Hall Operator, LLC is located at 1639 NE 26th St, Wilton Manors, FL 33305. The listed phone number is (954) 563-6232.

What is Independence Hall Operator, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Independence Hall Operator, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2281637) is associated with this NPI, valid through May 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Independence Hall Operator, LLC was last updated on November 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.