Organization
INDEPENDENT LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MILLER (OWNER)
(757) 639-6002
Entity
Organization
Contact information
Practice address
1128 CHARLESTON ST, NORFOLK, VA 23505-3132
(757) 639-6002
Mailing address
PO BOX 64386, VIRGINIA BEACH, VA 23467-4386
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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