Provider Demographics
NPI:1245598317
Name:DISABILITY SOLUTIONS FOR INDEPENDENT LIVING, INC.
Entity Type:Organization
Organization Name:DISABILITY SOLUTIONS FOR INDEPENDENT LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:MIRIAM
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:EXEUTIVE DIRECTOR
Authorized Official - Phone:386-255-1812
Mailing Address - Street 1:119 S PALMETTO AVE
Mailing Address - Street 2:SUITE 180
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4387
Mailing Address - Country:US
Mailing Address - Phone:386-255-1812
Mailing Address - Fax:386-255-1814
Practice Address - Street 1:119 S PALMETTO AVE
Practice Address - Street 2:SUITE 180
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-4387
Practice Address - Country:US
Practice Address - Phone:386-255-1812
Practice Address - Fax:386-255-1814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management