Independent Living Services

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

OTR-1868 Issued in AR

Legal business name

INDEPENDENT LIVING SERVICES

Practice address

1105 Deer St Ste 9
Conway, AR 72032-5450

Phone

(501) 327-5883

NPI assigned

Nov 4, 2008

Organization subpart

No

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

Authorized official

Name

Jackie Fliss

Title

Director

Phone

(501) 327-5234

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Independent Living Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Independent Living Services, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Conway, AR
  • NPI 1225166150
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robbin Hall, MS, OTR/L

  • Occupational Therapist
  • Coppell, TX
  • NPI 1457505406
  NPD (past)

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1245483262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 DEER ST STE 9",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325450",
            "telephone_number": "501-327-5883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 DEER ST STE 9",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325450",
            "telephone_number": "501-327-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT LIVING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "FLISS",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "501-327-5234"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "AR",
            "license": "OTR-1868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152002721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohamed Idrissa-Moussa, RECOVERY ASSISTANT
• Igh Homecare & Concierge Solutions LLC
• Ashley Nicole Iglesia, OT
• Haniya Imtiaz, MD
• Incite Rehab, LLC
• Independent Living Services, Inc.
• Julie Ingle
• Sherry Ingram, BEHAVIOR TECH
• Intensivist Group, LLC
• Intensivist Group,LLC

• Developmentally Disabled Services Day Training Agency in Conway, AR
• Providers in Conway, AR by specialty
• Developmentally Disabled Services Day Training Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.