Provider Demographics
NPI:1437427135
Name:LIVING INDEPENDENCE FOR EVERYONE OF MISSISSIPPI
Entity Type:Organization
Organization Name:LIVING INDEPENDENCE FOR EVERYONE OF MISSISSIPPI
Other - Org Name:LIFE OF MISSISSIPPI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:G
Authorized Official - Last Name:DUNAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-969-4009
Mailing Address - Street 1:1304 VINE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39202-3429
Mailing Address - Country:US
Mailing Address - Phone:601-969-4009
Mailing Address - Fax:601-969-1662
Practice Address - Street 1:1304 VINE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39202-3429
Practice Address - Country:US
Practice Address - Phone:601-969-4009
Practice Address - Fax:601-969-1662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable