Organization
SUPPORT FOR INDEPENDENT LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAISY ANGLIN MBA (EXECUTIVE DIRECTOR)
(610) 649-3148
Entity
Organization
Contact information
Practice address
2320 HAVERFORD RD, SUITE 220, ARDMORE, PA 19003-2913
(610) 649-3148
(610) 649-3148
Mailing address
2320 HAVERFORD RD, SUITE 220, ARDMORE, PA 19003-2913
(610) 649-3148
(610) 649-3923
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251T00000X
PACE Provider Organization
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
03/30/2011
Last updated
08/26/2015
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