Independent Living Therapy Services, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

INDEPENDENT LIVING THERAPY SERVICES, LLC

Practice address

12105 Dan Patch Rd SE
Albuquerque, NM 87123-2196

Phone

(505) 350-3069

Fax

(505) 508-2305

NPI assigned

Sep 29, 2010

Organization subpart

No

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

Authorized official

Name

Ivyrose Gonzales, MOTR/LNPI 1750538807

Title

Occupational Therapist

Phone

(505) 350-3069

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

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

• Ivyrose Gonzales, MOTR/L,ATC

  • Occupational Therapist
  • Albuquerque, NM
  • NPI 1750538807
  NPD Authorized official

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1710296496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 DAN PATCH RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871232196",
            "telephone_number": "505-350-3069",
            "fax_number": "505-508-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12105 DAN PATCH RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871232196",
            "telephone_number": "505-350-3069",
            "fax_number": "505-508-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT LIVING THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "IVYROSE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "505-350-3069",
        "authorized_official_credential": "MOTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93985312",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristina Incorvaia, PT
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• Independence Care of New Mexico at Albuquerque LLC
• Independent Drug Testing and Forensic Services
• Independent Living Resource Center
• Indian Health Service
• Indigo Grove Counseling LLC
• Indigo Midwifery
• Indigo Psychiatric Services
• Indigo Psychotherapy, LLC

• Occupational Therapist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Occupational Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.