Provider Demographics
NPI:1265095541
Name:INDEPENDENT LIVING RESOURCE CENTER
Entity type:Organization
Organization Name:INDEPENDENT LIVING RESOURCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-266-5022
Mailing Address - Street 1:7950 S LINCOLN STREET
Mailing Address - Street 2:SUITE 111E
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2727
Mailing Address - Country:US
Mailing Address - Phone:720-379-3642
Mailing Address - Fax:720-379-3164
Practice Address - Street 1:7950 S LINCOLN STREET
Practice Address - Street 2:SUITE 111E
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2727
Practice Address - Country:US
Practice Address - Phone:720-379-3642
Practice Address - Fax:720-379-3164
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INDEPENDENT LIVING RESOURCE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-22
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty