OrganizationActive
Independent Life Services, Inc.
NPI 1376798009 · Developmentally Disabled Services Day Training Agency · Mesa, AZ
Provider details
- NPI number
- 1376798009
- Entity type
- Organization
- Primary specialty
- Developmentally Disabled Services Day Training AgencyAgencies
- Authorized official
- Tyler Burke, President
Practice location
3641 E Southern Ave
Mesa, AZ 85206-2503
Phone: (480) 917-2034
Fax: (480) 917-2115
Mailing address
3641 E Southern Ave
Mesa, AZ 85206-2503
Registry dates
- Enumerated
- 2008-11-21
- Last updated
- 2008-11-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.