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General NPI Number Information
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NPI Number | 1023146966
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Entity Type | Organization
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Legal Business Name | INDEPENDENT LIVING INC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 474 NORTH FOSTER DRIVE
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City | BATON ROUGE
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State | LA
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Zip | 70806
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Country | US
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Telephone | 225-924-7998
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Fax | 225-924-7715
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Provider Business Mailing Address
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Address Line | 474 NORTH FOSTER DRIVE
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City | BATON ROUGE
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State | LA
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Zip | 70806
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Country | US
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Telephone | 225-924-7998
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Fax | 225-924-7715
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. JACQUELYN BLANEY
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Credential |
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Telephone | 225-924-7998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | SIL4190
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License Number State | LA
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