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Organization

INDEPENDENT LIVING INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARRIE GOTFRIED GUISE (DIRECTOR)
(813) 963-6923
Entity
Organization

Contact information

Practice address
6508 GUNN HWY, TAMPA, FL 33625-4022
(813) 963-6923
(813) 264-0768
Mailing address
6508 GUNN HWY, TAMPA, FL 33625-4022
(813) 963-6923
(813) 264-0768

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
106E00000X
Assistant Behavior Analyst
106S00000X
Behavior Technician
222Q00000X
Developmental Therapist
225100000X
Physical Therapist
225X00000X
Occupational Therapist
OT4289
FL
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
Primary
261Q00000X
Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024476200
FL
05
811496000
FL
05
884287600
FL
Enumeration date
05/19/2006
Last updated
07/24/2023
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