Provider Demographics
NPI:1952748964
Name:INDEPENDENT LIVING SOLUTIONS INC.
Entity Type:Organization
Organization Name:INDEPENDENT LIVING SOLUTIONS INC.
Other - Org Name:SYNERGY HOMECARE OF GREATER SAN ANTONIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BETTINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCGRIGGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-267-1252
Mailing Address - Street 1:14310 NORTHBROOK DR STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5051
Mailing Address - Country:US
Mailing Address - Phone:210-267-1252
Mailing Address - Fax:210-568-4077
Practice Address - Street 1:14310 NORTHBROOK DR STE 230
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-5051
Practice Address - Country:US
Practice Address - Phone:210-267-1252
Practice Address - Fax:210-568-4077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015725253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN