Organization
INDEPENDENT LIFESTYLES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN ALAN HOECHERL RN (ADMINISTRATOR/NURSE)
(414) 241-5010
Entity
Organization
Contact information
Practice address
4405 S DEERWOOD DR, NEW BERLIN, WI 53151-9240
(262) 782-6068
(262) 827-2642
Mailing address
4405 S DEERWOOD DR, NEW BERLIN, WI 53151-9240
(262) 782-6068
(262) 827-2642
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/28/2008
Last updated
11/28/2008
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