Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Independent Life Supportive Services

Organization Mental Illness Community Based Residential Treatment Facility · NPI 1417081167

Independent Life Supportive Services is a Mental Illness Community Based Residential Treatment Facility in Lake Orion, Michigan. Registered with an NPI since 2007.

In the registry since
2007

Practice location Address checks out

2912 Ravine Dr Apt 206
Lake Orion, MI 48360-2392
Phone: (248) 391-2787
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Illness Community Based Residential Treatment Facility (primary) Taxonomy 320800000X

Record details

NPI number1417081167
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brad Tankersley — Director Of Operations · (248) 391-2787
NPI enumeratedMarch 15, 2007
Last updated in NPPESAugust 22, 2020
Mailing address2912 Ravine Dr, Apt 206, Lake Orion, MI 48360-2392