Independent Lifestyles, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

INDEPENDENT LIFESTYLES, INC.

Practice address

4405 S Deerwood Dr
New Berlin, WI 53151-9240

Phone

(262) 782-6068

Fax

(262) 827-2642

NPI assigned

Nov 28, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dan Alan Hoecherl, RN

Title

Administrator/Nurse

Phone

(414) 241-5010

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227830400000",
    "number": "1124273479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 S DEERWOOD DR",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531519240",
            "telephone_number": "262-782-6068",
            "fax_number": "262-827-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 S DEERWOOD DR",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531519240",
            "telephone_number": "262-782-6068",
            "fax_number": "262-827-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT LIFESTYLES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-28",
        "last_updated": "2008-11-28",
        "status": "A",
        "authorized_official_last_name": "HOECHERL",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "ADMINISTRATOR/NURSE",
        "authorized_official_telephone_number": "414-241-5010",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.