Provider Demographics
NPI:1568705663
Name:INDEPENDENT LIVING ASSOCIATES INC.
Entity Type:Organization
Organization Name:INDEPENDENT LIVING ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:REM
Authorized Official - Last Name:SAULINO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:484-231-8484
Mailing Address - Street 1:1641 GALLAGHER CT
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2859
Mailing Address - Country:US
Mailing Address - Phone:484-231-8484
Mailing Address - Fax:
Practice Address - Street 1:1641 GALLAGHER CT
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-2859
Practice Address - Country:US
Practice Address - Phone:484-231-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management