Provider Demographics
NPI:1790153724
Name:RESOURCES FOR INDEPENDENT LIVING INC
Entity Type:Organization
Organization Name:RESOURCES FOR INDEPENDENT LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ONEILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-353-6503
Mailing Address - Street 1:4009 FITZHUGH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3953
Mailing Address - Country:US
Mailing Address - Phone:804-353-6503
Mailing Address - Fax:804-358-5606
Practice Address - Street 1:4009 FITZHUGH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3953
Practice Address - Country:US
Practice Address - Phone:804-353-6503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0087429871OtherAPI