# SP22INDEPENDENT LIVING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346979887
- **Authorized official:** SANDRA PARKER (OWNER)
- **Authorized official phone:** (213) 442-9068

## Contact information

- **Practice address:** 13191 QUIET CANYONS DR, VICTORVILLE, CA 92395-9239
- **Practice address phone:** (213) 442-9068
- **Mailing address:** 13191 QUIET CANYONS DR, VICTORVILLE, CA 92395
- **Mailing address phone:** (213) 442-9068

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/09/2022
- **Last updated:** 06/09/2022