Provider Demographics
NPI:1518281518
Name:INDEPENDENT LIFE SOLUTIONS
Entity Type:Organization
Organization Name:INDEPENDENT LIFE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:RK
Authorized Official - Last Name:TOMOSO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:808-280-5176
Mailing Address - Street 1:768 KEKONA PL
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-9028
Mailing Address - Country:US
Mailing Address - Phone:808-280-5176
Mailing Address - Fax:
Practice Address - Street 1:768 KEKONA PL
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-9028
Practice Address - Country:US
Practice Address - Phone:808-280-5176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-19
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT-495253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care