Organization
INDEPENDENT LIVING & SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM ANDERSON (PRESIDENT/CEO)
(757) 200-2094
Entity
Organization
Contact information
Practice address
1522 FLORIDA AVE, NORFOLK, VA 23502-1516
(757) 200-2094
Mailing address
3253 DUQUESNE DR, CHESAPEAKE, VA 23321-4032
(757) 483-9625
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
SS-195-05
VA
Other
Enumeration date
08/15/2008
Last updated
08/15/2008
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