Provider Demographics
NPI:1871889915
Name:DIRECTIONS IN INDEPENDENT LIVING, INC.
Entity type:Organization
Organization Name:DIRECTIONS IN INDEPENDENT LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:X
Authorized Official - Last Name:LIGUORI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-373-4602
Mailing Address - Street 1:512 WEST STATE STREET
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-3650
Mailing Address - Country:US
Mailing Address - Phone:716-373-4602
Mailing Address - Fax:716-373-4604
Practice Address - Street 1:512 WEST STATE STREET
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-3650
Practice Address - Country:US
Practice Address - Phone:716-373-4602
Practice Address - Fax:716-373-4604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02971126Medicaid
NY03857825Medicaid