Provider Demographics
NPI:1518356104
Name:LIVING INDEPENDENTLY FOREVER INC.
Entity Type:Organization
Organization Name:LIVING INDEPENDENTLY FOREVER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENOCHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-418-5665
Mailing Address - Street 1:550 LINCOLN ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-6233
Mailing Address - Country:US
Mailing Address - Phone:508-790-3600
Mailing Address - Fax:508-778-4919
Practice Address - Street 1:550 LINCOLN ROAD EXT
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-6233
Practice Address - Country:US
Practice Address - Phone:508-790-3600
Practice Address - Fax:508-778-4919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-20
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency