Provider Demographics
NPI:1508007006
Name:INDEPENDENT LIVNG SOLUTIONS
Entity Type:Organization
Organization Name:INDEPENDENT LIVNG SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUDREAU-MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-660-1094
Mailing Address - Street 1:20 VAUGHN ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:ME
Mailing Address - Zip Code:04950-1319
Mailing Address - Country:US
Mailing Address - Phone:207-660-1094
Mailing Address - Fax:
Practice Address - Street 1:20 VAUGHN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:ME
Practice Address - Zip Code:04950-1319
Practice Address - Country:US
Practice Address - Phone:207-660-1094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care