Provider Demographics
NPI:1114149218
Name:INDEPENDENT LIVING HOME SOLUTIONS, INC
Entity Type:Organization
Organization Name:INDEPENDENT LIVING HOME SOLUTIONS, INC
Other - Org Name:FRANCHISE FUSION, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:601-214-6134
Mailing Address - Street 1:PO BOX 1908
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39158-1908
Mailing Address - Country:US
Mailing Address - Phone:601-214-6134
Mailing Address - Fax:601-510-9521
Practice Address - Street 1:119 RIDGEFIELD DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-7488
Practice Address - Country:US
Practice Address - Phone:601-214-6134
Practice Address - Fax:601-510-9521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies