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Organization

INDEPENDENT LIVING SOLUTIONS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREA ANNELLE DAVENPORT (COO)
(423) 268-4383
Entity
Organization

Contact information

Practice address
4504 BRISTOL HWY STE 115, JOHNSON CITY, TN 37601
(423) 915-0023
(423) 915-0021
Mailing address
4504 BRISTOL HWY STE 115, JOHNSON CITY, TN 37601
(423) 915-0023
(423) 915-0021

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
L000000004327
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q017622
TN
Enumeration date
02/11/2010
Last updated
02/26/2026
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