Organization
ENVISION INC
Active
Parent organization
INDEPENDENT LIVING SOLUTIONS
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENT LIVING SOLUTIONS
Authorized official
MS. ANDREA ANNELLE TOWNSEND (CFO)
(423) 268-4383
Entity
Organization
Contact information
Practice address
4504 BRISTOL HWY, SUITE 105, JOHNSON CITY, TN 37601-3571
(423) 952-2211
(423) 952-2210
Mailing address
4504 BRISTOL HWY, SUITE 115, JOHNSON CITY, TN 37601-3571
(423) 268-4383
(423) 915-0021
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
L000000008670
TN
251J00000X
Nursing Care Agency
PSS0000000282
TN
253Z00000X
In Home Supportive Care Agency
L000000004327
TN
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
L000000008670
TN
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
L000000008670
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E56
—
TN
05
—
H445195
—
TN
Enumeration date
08/18/2009
Last updated
11/28/2022
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