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General NPI Number Information
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NPI Number | 1922120252
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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 | 04/06/2007
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 5 WASHINGTON TER
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City | NEWBURGH
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State | NY
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Zip | 12550-5338
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Country | US
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Telephone | 845-565-1162
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Fax | 845-565-0567
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Provider Business Mailing Address
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Address Line | 5 WASHINGTON TER
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City | NEWBURGH
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State | NY
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Zip | 12550-5338
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Country | US
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Telephone | 845-565-1162
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Fax | 845-565-0567
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Authorized Official
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Title or Position | COMPTROLLER
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Name | MS. REBECCA POTTER
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Credential |
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Telephone | 845-565-1162
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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 |
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License Number State |
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