Organization
INDEPENDENT LIVES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACIE HAZEL SELFRIDGE MS, OTR/L (CEO)
(978) 258-1673
Entity
Organization
Contact information
Practice address
10 MAIN ST, NORTH ANDOVER, MA 01845-2410
(978) 258-1673
Mailing address
13 MAPLE AVE, NORTH ANDOVER, MA 01845-2411
(978) 258-1673
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/07/2013
Last updated
10/07/2013
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