Provider Demographics
NPI:1902977044
Name:ADVOCATES FOR INDEPENDENT LIVING
Entity Type:Organization
Organization Name:ADVOCATES FOR INDEPENDENT LIVING
Other - Org Name:ADULTS IN COMMUNITY TRANSITION
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-279-8822
Mailing Address - Street 1:2520 HARTLEY ST
Mailing Address - Street 2:
Mailing Address - City:LAKEPORT
Mailing Address - State:CA
Mailing Address - Zip Code:95453-6932
Mailing Address - Country:US
Mailing Address - Phone:707-263-5230
Mailing Address - Fax:707-263-3927
Practice Address - Street 1:4795 GADDY LN
Practice Address - Street 2:
Practice Address - City:KELSEYVILLE
Practice Address - State:CA
Practice Address - Zip Code:95451-7407
Practice Address - Country:US
Practice Address - Phone:707-279-8822
Practice Address - Fax:707-279-8322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALTC6982619OtherMEDI CAL