INDEPENDENT LIFE SUPPORTIVE SERVICES
NPI 1417081167
Community Based Residential Treatment Facility, Mental Illness in Lake Orion, MI
About Independent Life Supportive Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INDEPENDENT LIFE SUPPORTIVE SERVICES (NPI 1417081167) is a healthcare organization registered as a community based residential treatment facility, mental illness in Lake Orion, Michigan and active in the NPI registry since March 2007. The organization lists Brad R Tankersley, Director Of Operations, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Independent Life Supportive Services's NPI number?
The NPI number for Independent Life Supportive Services is 1417081167. It was assigned to this organization in the NPPES registry on March 15, 2007.
Where is Independent Life Supportive Services located?
Independent Life Supportive Services is located at 2912 Ravine Dr Apt 206, Lake Orion, MI 48360. The listed phone number is (248) 391-2787.
What is Independent Life Supportive Services's specialty?
The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.
When was this NPI record last updated?
The NPPES record for Independent Life Supportive Services was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Independent Life Supportive Services · NPI 1417081167
Community Based Residential Treatment Facility, Mental Illness organization in Lake Orion, Michigan. Organization record, active in the CMS NPPES registry since March 15, 2007.
## Identity
- **NPI:** 1417081167 (Entity type: Organization)
- **Enumerated:** March 15, 2007
- **Primary specialty:** Community Based Residential Treatment Facility, Mental Illness · taxonomy 320800000X
- **Organization subpart:** No
- **Authorized official:** Brad Tankersley, DIRECTOR OF OPERATIONS
## Practice location
- **Address:** 2912 RAVINE DR, APT 206, Lake Orion, MI 48360-2392
- **Phone:** (248) 391-2787
## Record status
- **NPPES last updated:** August 22, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1417081167) · Data from the CMS NPPES public registry.