Provider Demographics
NPI:1003465550
Name:TRUE INDEPENDENT LIVING LLC
Entity Type:Organization
Organization Name:TRUE INDEPENDENT LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:OBAROGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-239-7393
Mailing Address - Street 1:1532 STEWART DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6599
Mailing Address - Country:US
Mailing Address - Phone:646-239-7393
Mailing Address - Fax:
Practice Address - Street 1:1532 STEWART DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6599
Practice Address - Country:US
Practice Address - Phone:646-239-7393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRUE INDEPENDENT LIVING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-07
Last Update Date:2019-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty