Provider Demographics
NPI:1558699801
Name:INDEPENDENT LOVING CARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:INDEPENDENT LOVING CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:219-764-9400
Mailing Address - Street 1:744 SWALLOWTAIL CT
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:46385
Mailing Address - Country:US
Mailing Address - Phone:708-516-7964
Mailing Address - Fax:
Practice Address - Street 1:744 SWALLOWTAIL CT
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-8191
Practice Address - Country:US
Practice Address - Phone:708-516-7964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251G00000XAgenciesHospice Care, Community Based
No385HR2050XRespite Care FacilityRespite CareRespite Care Camp