Provider Demographics
NPI:1174397301
Name:INDEPENDENT QUALITY LIVING HOMES LLC.
Entity type:Organization
Organization Name:INDEPENDENT QUALITY LIVING HOMES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LESLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-565-5312
Mailing Address - Street 1:2743 ROSEBAY LN
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35022-7245
Mailing Address - Country:US
Mailing Address - Phone:205-565-5312
Mailing Address - Fax:
Practice Address - Street 1:206 WOODMERE CREEK LN
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35226-3563
Practice Address - Country:US
Practice Address - Phone:205-565-5312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health