Provider Demographics
NPI:1942520721
Name:INDEPENDENT LIVING RESOURCE CENTER. INC
Entity Type:Organization
Organization Name:INDEPENDENT LIVING RESOURCE CENTER. INC
Other - Org Name:ILRC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:U
Authorized Official - Last Name:BLACKNELL
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MPA
Authorized Official - Phone:805-963-0595
Mailing Address - Street 1:423 W VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:423 W VICTORIA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3619
Practice Address - Country:US
Practice Address - Phone:805-963-0595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management