Organization
INDEPENDENT LIFE ANNEX
Active
Organization
INDEPENDENT LIFE ANNEX
Active
Other names
Ilahouse
Organization subpart
No
Provider details
NPI number
Authorized official
DEDRIC ASHLEY (OWNER)
(469) 712-4452
Entity
Organization
Contact information
Practice address
6610 GREENSPRING DR, ARLINGTON, TX 76016-5134
(469) 712-4452
Mailing address
PO BOX 155046, IRVING, TX 75015-5046
(469) 712-4452
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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