Organization Name: | INDEPENDENT LIFESTYLES, INC. |
NPI Number: | 1124273479 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAN ALAN HOECHERL (ADMINISTRATOR/NURSE) |
Mailing Address: | 4405 S Deerwood Dr New Berlin |
State: | WI US |
Postal Code: | 531519240 |
Phone Number: | 2627826068 |
Fax Number: | 2628272642 |
NPI Enumeration Date: | 11/28/2008 |
NPI Last Update Date: | 11/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Physical Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |