Provider Demographics
NPI:1912028580
Name:LIVING INDEPENDENTLY FOREVER, INC.
Entity Type:Organization
Organization Name:LIVING INDEPENDENTLY FOREVER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-888-0076
Mailing Address - Street 1:8620 W EMERALD ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-4824
Mailing Address - Country:US
Mailing Address - Phone:208-888-0076
Mailing Address - Fax:208-888-1335
Practice Address - Street 1:8620 W EMERALD ST
Practice Address - Street 2:SUITE 150
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-4824
Practice Address - Country:US
Practice Address - Phone:208-888-0076
Practice Address - Fax:208-888-1335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management